FODMAPs Checklist

The low FODMAP diet is an evidenced based elimination diet shown to manage symptoms in 75% of those with IBS. The majority of the studies on the low FODMAP diet utilized a registered dietitian (RD) to help implement the diet. Work with an RD knowledgable in the low FODMAP diet to be sure you are following it correctly. The diet has many nuances making it a challenging diet to implement on your own. Note: the low FODMAP diet is a learning diet to help the person with IBS determine their personal trigger foods. The diet has been shown to reduce probiotic bacteria in the colon and the long-term impact of this has yet to be determined. The goal of the diet is to minimize symptoms while eating the most varied and healthy diet as possible.

873 thoughts on “FODMAPs Checklist”

Thank you so much Kate, incredibly grateful for your time and effort. What a relief to have found your site – such a helpful resource given the plethora of confusing and often conflicting information about FODMAPS.

I am about to collect pen, paper and coffee in order to read back through your archives!

Ooops, forgot the question I originally wanted to ask! I find myself incredibly confused about soy; everything I have read elsewhere tells me I should avoid soy beans (galactans are problematic for me), and yet tofu appears here on the FODMAP friendly list?

The processing of soy into tofu removes most or all of the FODMAPs and it is primarily protein. The Australian researchers that created the low FODMAP diet have allowed it on the diet. Soybeans, soy flour and some soy milks will still be potential FODMAP sources.

Galactans are know referred to as GOS these days–just so you know when reading current info. Soy protein isolate should just be the protein of soy and therefore should be low in FODMAPs but when I look at the nutritional info it lists it contains fiber so I would have to say that I am not sure–it likely varies amongst products. It certainly would be a good choice to try when undergoing a GOS challenge.

Many thanks Kate – and apologies if ongoing questions are frustrating, I *am* both experimenting with diet and also trying to research these things myself, truly! Back to the issue of conflicting information however, I really appreciate being able to ask a source I trust.

The tofu issue makes sense (and is a relief, actually). Tempeh, however, I would understand still likely to be problematic for those of us struggling with galactans; different processing, and whole beans – would you agree? Man, what a shame, I love the stuff (diet trials would also suggest my body does not …)

Shona, not sure that cocoa has been officially tested but I know it was used in one of the Monash studies (where FODMAPs originated) on the low FODMAP diet part of a study so I am think in moderate doses it will be okay. I am not a fan of sucralose though as one study suggests that it alters healthy gut bacteria. Sub in maple syrup or a bit of table sugar perhaps?

Hi Robin-
Not all the recipes on my site are low in FODMAP–I specify which ones that are low FODMAP in the post. Both cauliflower and broccoli are on my checklist. Broccoli is a moderate fructan/GOS–allowed in 1/2 cup serving on elimination phase. Cauliflower is rich in polyols–not allowed on elimination phase. http://blog.katescarlata.com/fodmaps/fodmaps-checklist/

Avocados are allowed 1/4 of avocado. Beans are eliminated in the elimination phase. Nuts okay as listed on checklist (no pistachios) Coconut milk okay.
Tofu okay, soy sauce okay–not sure about Miso and tempeh–not sure they have been evaluated yet.

According to the Monash University Low FodMap diet Edition 4 Booklet, Tempeh 150gm is low and has a green code. Same with Tofu 1/2 cup. I would suggest getting an organic naturally made without additives and check ingredients for flavoured ones.

Yes, Robin, it is a diet that is best provided with a RD that is skilled in all of it’s nuances! My clients seem to understand it very well and it has made a world of difference for a vast majority of them.

Oat milk and rice milk seem to be okay–always read labels for other ingredients that may be added such as chicory root extract that are problematic. Soy milk varies depending on processing. UK low FODMAP booklet lists Alpro-unsweetened long life or Original chilled, So Good products as low FODMAP–not sure if those products available in Norway. Glad you found me Ingrid!

Thank you, Kate!! I have been thinking of using it again as a supplement in my son’s diet. . .adds great flavor and some protein to fill in the gaps. We haven’t been brave enough to try it since starting the low FODMAP diet.

Hi Kate! Good to know about tofu – I had been leaving it out because I assumed it was exactly the same as eating soybeans.

One question though – this is the first checklist I’ve seen that has pumpkin as a problem food. Eek! Can you confirm exactly which type of pumpkin you’re referring to? (I’m in Australia, so I know the terminology can sometimes be different for certain vegetables between Aus and US). Also, do you have any info on the exact amount of fructose and glucose in pumpkin, or know where I could get this info from?

Emma-butternut pumpkin should be limited to 1/2 cup( that would be butternut squash in the US) and the US info on our (big round orange) pumpkin shows it as a mannitol source BUT the Australian info–straight from Monash University in Melbourne says Pumpkin is OK–so I think for you in Aussie–pumpkin as you call it, is low in FODMAP. Tofu, because of the way it is processed makes it okay-low FODMAP and some soy milks too are OK such as SoGood is low in FODMAP and Bonsoy in 1/2 cup serving is low in FODMAP too, while Vitasoy, is high in FODMAPs. So MANY details to work out, right?
Hope that helps a bit!
Kate

Emma, I was fortunate to attend a great educational session for dietitians at Monash U last September and learn the latest information on the diet where the diet originated and the bulk of the research is done.

Emma,
Not sure where in Australia you are located, but Dr. Sue Shepherd has three clinics in Melbourne and a team of educated dieticians (see http://www.shepherdworks.com.au).

She’s also been touring Australia educating GPs about the low FODMAP diet (LOL, even my GP!) and has been educating many dieticians too. Many health professionals are becoming more and more educated on the science behind the diet. See if your dietician can get in touch with Sue

I was wondering if tapioca starch and arrowroot are allowed – they seem to be in a lot of gluten-free products.

Also, are stabilizers like guar gum, locust bean gum, xanthan gum, and cellulose OK? They are in a lot of products. I am particularly asking about the guar gum, since it’s also used as a fiber supplement.

We don’t have access to all the recent foods that the Australians have tested so some of the low FODMAP diet is based on info that is available from various older sources and may not be that accurate. With that in mind, tapioca and arrowroot seem okay but that could change. The gums can be fermentable but are not considered FODMAPs–so in small amounts should be okay. Bottom line: Choose more natural whole foods such as carrots, strawberries, oats, potatoes, rice etc. rather than “products” and you will avoid many of these stabilizers and fillers anyway

I seem to be sensitive to many foods on the FODMAPS list and I noticed on a lab test few yrs ago i was “fructose sensitive” but the ND made special attention to it and brushed it off when I asked. NOW I know there IS more to it and have been googling this month about it. I wish I had known this list 15 yrs ago. But, I’ve had IBS for 10 yrs and tried all the typical anti-candida and IBS diets. I seem to be sensitive to Tapioca. It’s sticky when you make bread and seems to digest slower for me, like sticking in my gut. So,I’m not a fan of it. Interesting to hear about the GUMS being capable of fermenting. Good reason to avoid them. THANK YOU

Steve-
The US data on raspberries note them as high in excess fructose so I have left them in the high category. Aussie research does in fact have them in the low category. Since growing conditions may impact food composition I am hesitant to move them into the low category quite yet….hope to have US raspberries analyzed by Aussie researchers.

I was wondering if you have ever come across anything regarding oils. Any that should be avoided? Palm oil (which I suspect I have an issue with), Cottonseed oil, soybean oil, vegetable oil, canola, avacado, etc. Does turning anything that is low fodmap up the concentration when it becomes an oil? Any direction would be appreciated!!

I don’t know if it is ok to comment on an older post like this, but I just wanted to note that there is likely a difference between wild and cultivated raspberries that have been selectively bred to produce sweeter berries. We have a lot of wild raspberries growing along the edge of the woods on our property (in Maryland) and they are never as sweet as the store-bought ones or ones grown in home gardens from “new and improved” varieties.
Just a thought about the possible discrepancies!

Hi Kate,
I am wondering if almond milk is considered okay as a milk substitute. I am also wondering if vegetables that aren’t on your caution list yet also aren’t on the fodmap friendly list would be okay. I am thinking specifically of swiss chard and parsnips.

Parsnips should be on my list (oops!) Thanks for the catch! Not sure Swiss Chard has been tested by the Australian’s yet. The Monash University researchers should be publishing their food composition booklet and then we will all have so much more info!!

What happens if someone makes a mistake during the elimination phase? Do we have to start the 6-8 weeks all over again? I’m generally a conscientious label-reader, but I accidentally drank some herbal tea that contained chicory!
Thanks,
Cory

Hi Kate, thanks for this updated chart! FODMAP has made a huge difference in my IBS-D symptoms. I am an RD and also on my own journey to control my IBS vs it controlling me.

For the last several months, I have developed new symptoms. Epigastric pain centred beneath breast bone. We have ruled out peptic cause (had scope and was clear, no gastritis, ulcers, etc.) The gastroenterologist has now recommended I revisit gallbladder as potential cause – blood work is fine, no inflammation of gallbladder on u/s but I do have gallstones.

Can IBS symptoms change like this? I have always coped with IBS-D but these symptoms are new x 7 months. I have this pain 3 to 4 times a week. However, at times it flares up to the point it is debilitating.

Also, the gastro suggested I start a probiotic (tru zen) but I see it is on your caution list. Any advice?

Certainly folks with IBS have various symptoms that can change over the course of their life. I wonder about small intestinal bacterial overgrowth? Have you been tested for this? It’s hard for me to give case by case advice without looking at your full medical history but some things I may consider would be enteric coated peppermint oil to help with the pain–lots of research on this in IBS and perhaps a trial of a probiotic that doesn’t contain prebiotics such as culturelle health and wellness formula.

Hi Anita Eggink,
I’m just now reading your posts re: epigastric pain. If you continue to have this problem, you might want to read up on para esophageal hernia. I’m not suggesting you have one, but read the symptoms to see if they fit. It turned out that the cause of my epigastric pain (intermittent yet quite severe over many months) was the result for it. When the pain was severe, I felt like I was having a heart attack. The description of what happens with a para esophageal hernia describes why you get epigastric pain.
It took forever to get a diagnosis as my GI didn’t believe that was the issue. I finally had a consult with a thorough GI surgeon who diagnosed me. Surgery rectified the epigastic issues I was having. Thank goodness, because it can be a life threatening condition.

Kate, would over doing it with pumpkin seeds cause an IBS “flare-up”? And possibly a GERD flare-up as well? I was a little stressed and hungry yesterday and had way beyond the 1-2 tablespoons you suggest. I started feeling bad last night and am completely miserable today (bloating, gassy, burping). My stomach is churning! Since my doctor put me on the FODMAP diet I haven’t felt like this (over 6 weeks now) and the pumpkin seeds are all I can pinpoint. Thanks!

Thanks again! I finally started feeling better on Sunday and will be sure to limit the pumpkin seeds from now on. Amazing how foods can affect us like this! I love all that I am learning from your site!

I know that for nuts the serving is only a handful. Is that included for nut butter/peanut butter also? So for instance, If I have a handful of almonds in one day…. Can I have almond butter or peanut butter later in the day? If so how long should I wait in between?

Courtney-This is a great question. An orange is acceptable as it has a limited amount of fructose in it, and a balanced glucose:fructose ratio. But when to make juice, you need lots of oranges, so the amount of fructose you consume may be over your personal threshold. This is known as a “fructose load”. We don’t have good studies looking at how much fructose makes a food or beverage too much of a fructose amount for the individual with IBS, so when it comes to juice the current recommendation is just 1/3 cup of orange juice–not too much, right?!

I have not been tested for intestinal overgrowth. I am taking Tru Zen as a probiotic and am not sure if it is helpful. It is very expensive so I want to be sure it is helpful. I can not buy the enteric coated peppermint oil locally and plan to investigate the next time I am in the closest major centre.

The crux of the matter is the cause of the epigastric pain I am having has not really been diagnosed. A gastrocopy ruled out peptic issues and a trial of an acid inhibitor was not helpful.I haven’t been able to find a link to diet to minimize the issue.

I have gallstones and the thought is they are too big to leave the gallbladder but could be pressing up against the duct causing the pain. The pain is centered right beneath my breastbone. It is not daily. When I have it it can last as little as 1/2 an hour or be several hours in length. Severity of pain also varies.

I am having more tests for gallbladder but these are not typical signs of gallbladder problems. I would HATE to have my gallbladder removed which is where this is leading with the hope it helps.

What is your thought on could it be from the transverse colon? My doctors said no.

On a positive note, I have been trialing the FODMAP approach since September and my symptoms of IBS-D (intestinal cramping, urgent need to defecate, diarrhea) has been most improved.

I am an RD myself and I have been very interested in the FODMAP research happening. Any thoughts you have would be greatly appreciated.

Anita, You wrote this so long ago, so I sure hope you have total relief of your symptoms by now. I found that I had excess bile in my system and I am taking Welchol now, which is helping a ton. Your symptoms were like mine, so I thought I’d mention it.

Thanks for sharing this important point, Sue. There is a condition called Habba syndrome which presents with IBS-D like symptoms. This syndrome is a form of bile acid malabsorption–and diarrhea is common immediately after meals. Here is a good review: http://ibs.about.com/od/causesofibs/a/Habba-Syndrome.htm

Hi Courtney- I would imagine it would be a minimal amount but I really don’t know the answer! I recommend to my clients to avoid those additives in supplements and medications when possible as FODMAPs have a cumulative impact on symptoms–avoiding them when possible at least on the initial phase of the diet.

Hi Kate,
Is there a difference between HFCS and regular corn syrup, in terms of FODMAPs? Also, where does glucose fit into this? It’s in a strawberry jam I have.
Has algae been tested for FODMAPs? Or hemp seeds? Also, I realized I’ve been assuming that chocolate (dark chocolate, with real sugar) is OK. True?
Thanks ,
Cory

HI Cory,
Yes HFCS is a definite NO as it is a source of excess fructose. In general, we have allowed corn syrup but with further testing this may change-syrups are complicated.
Glucose is well absorbed so not considered a FODMAP. I do not believe algae or hemp seeds have been tested yet. Chocolate is another grey area as I have not seen the analysis on FODMAP content anywhere, but I do allow in small portion. Chocolate seems to be is a big trigger for many with IBS though so small portion again, is key. Hope that helps.

Thanks Kate! I have been avoiding HFCS very carefully (even before FODMAPs), but was hoping that a little regular corn syrup once in awhile would be OK : ) Good to know about the chocolate portions – I think I’ve been overdoing it lately.

And on a slightly different note, are bok choy and napa cabbage both OK on the FODMAP diet? Bok/pak choy, napa cabbage, and white turnips are all classified as Brassica rapa (unlike other cruciferous veggies), so I was hoping to branch out to napa for a different texture – so much bok choy lately!

The low FODMAP diet is not necessary a Lactose free diet but rather a low lactose diet. The trace amounts of lactose found in butter are allowed on the low FODMAP based on the guidelines of the researchers that proposed the diet. Certainly there are individuals with IBS that can not tolerate dairy altogether…but that in not a FODMAP issue but likely something else in the dairy that is triggering the symptoms.

Honestly, I don’t think that napa cabbage has been evaluated for FODMAPs. Turnips are low in FODMAPs per the Australian booklet.
I would perhaps try a napa cabbage challenge when you are ready to start challenging foods.

Hi Kate,
When it comes to baking I’m a big fan of using Sucanat in place of regular sugar because of it’s vitamin and mineral content. I’ve seen it listed on the safe list somewhere, what’s your take on it?
Thanks as always!

Stephanie-
From what I understand Sucanat has some molasses in it which may be a source of excess fructose per USDA info. Most of the sugar in sucanat is sucrose which is considered a low FODMAP choice. Not sure it would be enough molasses to be a major trigger for those with fructose malabsorption so try with caution and assess symptoms.

I do have sibo, although not been tested. Antibiotics were recommended by my naturopathic dr. about 8 yrs. ago. They completely took away all the symptoms. Since then I have been on numerous antibiotics and I am getting tired of this. Xifaxan is expensive and I’m concerned as it is not working like it used to. My quesstion is can sibo symptoms be kept at bay with fodmaps diet after a round of antibiotics?

Hi Kate! another question! Did you ever get diagnosed with sibo? If so, what did you do to get past the symptoms? I always gain weight with sibo without really eating much of anything. Any comments would be great! Thanks!

I believe the FODMAP to be cautious is the polyol group. Some beers contain mannitol. Alcohol is a irritant to the gut so limited intake is advised. (also if gluten intolerant beer may contains barley a source of gluten)

In response, and just to clarify; Wheat beers (beers made with wheat and barley) like Hefeweizen are ok and FODMAP friendly, just consume them in small quantities.
Thank you very much for your quick response.

We don’t have info available on many soy products. I don’t allow tempeh at this point. As the diet evolves and we have more food analyzed that may change. Tofu is okay but soy flour, some soy milks (US brands not tested yet that I know of), and the soybean itself would not be allowed.

Hi Kate! I was wondering if there was any difference in FODMAPs between raw honey and refined honey. I know nutritional value is quite different. It really helps with my seasonal allergies but I don’t want to trade one problem for another. Thanks!

Jaimie- I have not seen any literature looking at the nutrient composition differences –particularly measuring fructose content in raw vs. processed honey. My guess is that there would not be a significant difference. Honey contains excess fructose and not other FODMAP groups so for this reason, you could try to consume a bit of glucose when you consume a small amount of it and this may aid its absorption. This is only applicable when a food contains only excess fructose compared to glucose and NO other FODMAP groups….mango and honey would be the most common examples that I can think of. 1 TB honey has 8.6 g fructose and 7.5 g glucose which makes it a source of excess fructose. For some individuals, taking a glucose tablet which often contain 5 g glucose can help offset the excess fructose and help your body absorb the fructose. better. Of course, work with a health professional to work out these details to best suit your health needs.

Hi, thanks for all this info.
I’ve been following the diet as best as i can for a while now, and for the most part it’s helped me a great deal. I am waiting to see a gastroenterologist and the moment.
I am also trying to lose weight, so finding it pretty hard.
My big issue is yogurts. Trying to find lactose free low fat yogurts in the UK is impossible.
I use currently either Arla’s Lactofree or Alpro’s Soya Yogurts.
I have read loads on Soya products and I am very confused. The Alpro Soya Milk, yogurts etc are lactose free, so I thought they’d be fine. Are they okay?
I have trouble finding sweet snacks, I love the Sainsburys Free From ranges, but some do have inulin in so that can be tricky too.

Kings College London has GREAT low FODMAP resources and includes some UK brand name information. I would strongly encourage you to follow up with an RD in the UK that has accomplished Kings College FODMAPs course which seems to be very comprehensive from what I hear. Alpro plain yogurt is deemed low FODMAP in the Kings College booklet that I ordered. Other lactose free yogurt include Lactofree strawberry and raspberry yogurt. (In the US we are cautious to allow raspberries as our info has it a source of excess fructose)but it is allowed in UK and Aussie. Soy is a problem when the GOS remains in the final product so some soy products are not allowed including some brands of soy milk and yogurt and soy flour.

I noticed in some of your responses you mention each country has foods that may or may not be FODMAP safe (i.e., pumpkin in US vs. AUS). Does this mean a low FODMAP may vary between countries? Also, where would I be able to find a list of which foods are safe for my area (i.e. Canada)?

Marie,
That is a very good question. Manufacturing of foods and growing conditions may impact FODMAP content, that has yet to be fully explored. For now, we all rely on the AUD list for the bulk of the info. For some US foods-pumpkin and raspberries the info in inconsistent with the AUD info so I restrict on my check list–at least for now.

Karla,
These are great questions…so many foods have not been tested so there remains a ‘grey’ area and we do our best educated guesses. I have not seen actual data on FODMAP content for almond milk or almond flour. Most of my clients have tolerated almond milk in normal serving–4-8 oz per sitting. Almond flour may be best in smaller portion as it contains the whole nut– additionally it is quite high in fat with 14 grams per 1/4 cup. Fat is not a FODMAP issue but many people with IBS have trouble with high fat meals as well.

Not sure figs have been tested and since it would be concentrated fruit anyway would say no on that. Carrageenan should be okay but I have not seen definite data on that. Maltodextrin technically should be low in FODMAP–but it is a bit tricky to know for sure as likely different manufacturers manipulate it….but that being said I do allow for now. The diet continues to evolve….it is a new diet, so stay tuned.

This is the ingredient list for my favorite protein bars. Are any of the listed ingrdients not okay for the fodmap elimination? My concern was the inulin and the milk protein but perhaps the inulin is listed fare enough down to only contain a negligible amount? I am guessing milk protein isolate contains no carbs and thus nod fodmaps. Anything else signal an alarm?

Rice, almond and coconut milk without any other FODMAP ingredients should be okay. Soy milk varies. I have not seen any data on US brands yet-info from my last twitter chat on FODMAPs provided this great info from one of the Monash researchers –>soy milks made with whole soybean would be high FODMAP and soybean extract would be lower FODMAP.– If you can find a coconut yogurt without inulin–please share. Manufacturers are adding inulin to everything from cream cheese, yogurt even sugar-free carnation instant breakfast….ugh! READ ingredients ALWAYS.

By the way, thank you so much for your responses! I love having a trusted go-to expert for IBS and FODMAP issues It means a lot to so many people. I am studying to be a nurse practitioner and I might specialize in GI. I will reccomend your book and website to many IBS sufferers.

Thanks Alexandra…GI patients need compassionate and educated health care practitioner’s. I do my best, but continue to learn more each and every day. I don’t have all the answers but try to share what I do know.

I just have one quick question regarding probiotics. I have just visited a dietician and I have started on the Fodmap elimination diet. She has recommended I start taking a probiotic, Polybac 8. I am a little concerned to do this now as I see that probiotics are listed in the high fodmap section of the chart.

Probiotics that contain the fodmaps– FOS and inulin (fructans) should be avoided during the elimination phase of the diet. I am not familiar with Polybac 8 but from what I have seen online it does not appear to contain these prebiotics– so may be okay.
Typically I start the diet first to see how symptoms improve–and then add the probiotic next step so it is easier to figure out which changes have impacted your symptoms.

Thank you so much for this information! I am still learning new information everyday! What about lunch meat? Is that high or low fodmaps? How is a ripe banana low fodmaps, and an unripe banana high fodmaps (I saw this on another website)?

Simple lunch meat should be okay unless seasoned with garlic or onions. FODMAP content CAN vary in produce depending on ripeness. Although a firm banana has less overall fructose than a ripe one, both firm and ripe banana still have more glucose compared to fructose so don’t think ripeness would really matter that much in bananas.

Is coconut flour high fodmaps? I had some this morning and felt some effects afterwards. I never thought of it, but since coconut is fruit it probably contains fructans. Also, during the elimination phase, do I have to avoid all high and low fodmap foods?

Melissa–Coconut flour has soooo much fiber. My Bob’s Red Mill brand has 5 grams of fiber in just 2 tablespoons… so I do think it might be a troublemaker. I have not seen the FODMAP content for this flour so can’t say for sure. When on the elimination phase just stick with the low FODMAP foods listed in my check list and avoid all cautionary high FODMAP foods.

On the subject of coconut, I’m excited that coconut milk was found to be low-FODMAP. Are you aware of a specific allowable amount, like have <1/2 cup sweet potato or 1/4 avocado? Would like to add back into my diet in smoothies and soups but don't want to over do it.

I have not seen actual numbers on coconut milk–just heard that it was low FODMAP from the Aussie researchers present on the last twitter chat….BUT –the new composition booklet from Monash U should be out sometime soon–hopefully–and we’ll so much more info. Perhaps start with a small amount (1/2 cup) and see how you do.

Fructose, sorbitol and mannitol may pop up in the list of ingredients…probably not that much in a pill but still want to be cautious. I believe the Garden of life Ultra digestive enzymes are free of FODMAPs.

Kate, I love the Low FODMAP diet. The best for IBS.
I need a probiotic that is safe. You mention Wellness Formula. It has garlic in it. Culterelle doesn’t have enough organisms. I’m looking for something between 250,000-350,000. Also on the old and new FODMAP check list there is a quanity listed at the top. Less than .5gm per sitting, fructose less than 0.2g/serving, fructans and Polys less than 0.2 and 0.3g servings. I don’t know what that calculates out per serving size. How many cups, ounces or spoonfuls? Also in the black column the serving size is noted, does that pertain to the FODMAP friendly columns also? Or just the High FodMaps? Thanks

Hi Rhonda, Not sure what Wellness formula you are referring to…that has garlic in it? The culturelle (natural health and wellness formula) that I refer to does NOT have garlic to the best of my knowledge…perhaps there is a different brand you are thinking about. Number of organisms in a probiotic vary that is true BUT more is NOT definitely better. Most importantly you want to use a probiotic for the symptom or condition you are trying to manage and that you look at research into how much is necessary (in evidenced based medicine) to help manage that condition. There is so much mis-information about probiotics but a great resource is the World Gastr. Report found at the bottom of this reply.
In regard to the cut off numbers on top of the column’s that is info really for the future when the Australian composition book is published–soon I hope. If certain amounts are mention in cups/or portions that is because they do have FODMAPs but the portion list should be tolerated okay.

Hi! I have recently had a lot of success using the FODMAP approach to improve my IBS symptoms (cannot tell you how glad I am to finally have some control over it!).

There is one thing I was wondering however – barley malt extract seems to be in all breakfast cereals here in the UK, I don’t know whether this is the same in the US. As it is “extract” I thought it probably wasn’t a fibre and therefore couldn’t be a FODMAP but I have noticed that too much of even non-wheat cereals (e.g. rice crispies, corn flakes) seem to cause me a bit of trouble. Do you think that it could be the culprit? The other possibility is that I don’t do corn so well …

Not sure if this has been addressed yet, but are you aware of any liquid or gummy multivitamins that are FODMAP friendly? I recently found one called Slice of Life that says allergen, casein and gluten free. Glucose syrup as well as natural flavors and colors are added. Finding one without added sugars is challenging! w

A liquid or gummy vitamin almost HAS to be sweetened or it would be extremely tough to consume–vitamins alone don’t taste very good.
Some of my clients like the vita fusion gummies. http://www.swansonvitamins.com/VFS003/ItemDetail I believe they just added a peach flavor which is new and I don’t think would be an issue but the other citrus flavored should definitely be okay.

Kate,
What about GF Brown Rice and GF Brown Rice pasta products? There is conflicting info posted on other sites about this. According to the chart above (which is what I use to shop with), it appears that the GF rice and GF rice products should be safe, but I just want to be sure for BROWN rice.
Thanks!

Susan,
The supplemental powder likely has lactose due to the whey concentrate and sweet dairy whey.
Soy milk–If soy milk is made with Whole soy beans it tends to be high in GOS–a FODMAP source, soy milks made with soy protein tend to be lower in GOS so likely could be consumed in normal serving size portion. I haven’t had a moment to look at the US soy milk options to see if any would fit this criteria set forth by the Monash researchers.

Are you working with a dietitian to help you with your weight management? It may be a great idea to reach out to a FODMAPs knowledgable dietitian. My colleague, Patsy Catsos who is also a FODMAPs expert has a list of dietitians on her website http://www.ibsfree.net

Hi Kate. I have another soy question for you. I know you got a lot, but this one you haven’t been asked yet I don’t think and I’ve been wondering about it. I’m a vegan and have to be on a low FODMAP diet. Being a vegan and on a low FODMAP diet has been a bit hard. I have to make sure I get enough protein. That being said, I rely on tofu a lot. My question is about a tofu product I found that seems to be FODMAP safe, the only questionable ingredient I found is that it has ‘Isolated Soy Protein’. I’ve seen this ingredient in some other random products like bread, but I just stayed away from it thinking it was not FODMAP safe, but I want to ask you, a professional, what you think. Here is the link to the vegan cream cheese product I was looking at. It’s made by Tofutti. Just click ‘Read the Label’ below the picture to see the ingredients list. What do you think? Is ‘Soy Protein’ or ‘Isolated Soy Protein’ a FODMAP safe ingredient? Like I said, I’ve seen ‘Soy Protein’ as an ingredient in some other foods, so hopefully you can let me know if it would be safe or not. Thanks Kate.

I believe isolated soy protein should be low in FODMAPs. It is the carb portion of the food that has the FODMAPs not the protein. Soy protein should also be low in FODMAPs–may not be completely free of FODMAPs but lower that whole soybeans.

Cauliflower would not be consumed on the low FODMAP diet as it is a source of mannitol. Butternut squash may be consumed 1/2 cup per sitting–you could have it twice in one day but limit to one serving spaced about 3 hours apart.
If you were to choose 2 moderate fructan/GOS foods at one meal you may be over you FODMAP tolerance point—those moderate choices should be limited to one choice per meal.
Hope that helps!

US Pumpkin has not been tested for FODMAPs but will be early next year when I send some to Monash to be tested. It may be a source of mannitol, one of the polyols. It gets a bit confusing because the Australians call some squashes pumpkin so say that Japanese ‘pumpkin’ is okay but they are not referring to the pumpkin we eat in the US. Ironically, I am working on a recipe with pumpkin today–and I think for some on the low FODMAP diet it will be tolerated just fine. Mannitol malabsorption is less common than sorbitol malabsorption and I do find that many of my IBS clients can tolerate the mannitol containing foods (mushrooms, cauliflower) in reasonable amounts.

I am not a fan of the sugar substitute sucralose–it has been shown in studies to alter beneficial gut bacteria. The Quaker lower sugar oats has sucrolose. Why not just use quick oats and drizzle with a little maple syrup–that would be FODMAP friendly?

Apples are not allowed so no the Quaker apples and cinnamon instant oatmeal would not be a good choice. Plain oats with a drizzle of maple syrup would work with some blueberries. Table sugar and maple syrup are considered low FODMAP choices in small quantity. I am not a fan of sugar substitutes…but aspartame and stevia seem to be well tolerated.

Hi,
I am just starting the elmination phase. I am confused about leafy greens, there seems to be so much conflicting information.
I usually eat a lot of kale, swiss chard, spinach, collard greens, dandelion greens, beet greens etc. But since beets and dandelions are on some no lists, does that mean that their green tops are too? and kale is a relative of broccoli so is it high in FODMAPs too?
I also have noticed that oats cause a huge problem for me, so it’s strange that they are not high FODMAPs. I know they have a protein that is similar to gluten (avenin) – but in far less quantities. It’s weird because oats seems to be worse for me than gluten containing grains like spelt. Do you have any thoughts on what I could be reacting to in the oats?
thanks so much!
Sarah

Hi Sarah,
Leafy greens vary in FODMAP content. Spinach and Swiss chard have been tested and are low in FODMAPs. Dandelion greens are high FODMAP. Beet green, collard greens and kale–I have not seen info on for FODMAP content. The Monash team was testing kale recently–but I am not sure the results are out as of yet. Kale is a relative of broccoli so I am expecting it might be an issue. It could be the saponins in oats troubling you or perhaps an issue with the protein component. I do have a few clients that have trouble with quinoa and I wonder if this is due to the saponin content. There is scant literature about saponins making the gut more permeable –an area of digestive health that is interesting but needs to be studied more in humans. 100% spelt is lower in FODMAPs and often well tolerated.

Kate – your blog is an amazing resource – thanks! I’m glad to hear that more research is being done in the US. You mentioned that coconut milk is OK. Could you please clarify which kind assuming there’s a difference. I think I react to canned coconut milk used for curries but not the coconut milk that is used as a milk substitute.

Thank you! I think coconut milk in any variety should be okay from a FODMAP standpoint unless there are unsuitable additives added to it. Curries often use the full fat coconut milk and fat can be an IBS trigger–additionally other curry ingredients such as onion, garlic and broths if added can up the FODMAPs too. I encourage the light variety of coconut milk and not to go overboard–maybe 1/2 cup per sitting.

Kristina- Yes Arugula (rocket) was recently added to the okay list, radishes and green beans are okay too! There are many outdated lists online. I am working on updating my checklist this weekend if time allows.

Elaine-That is an excellent question. I have not any research on capers BUT Sue Shepherd one of the FODMAP researchers included capers in her low FODMAP recipe book so I think they would be worth a try. Because testing foods for FODMAP content is labor intensive, expensive and really only done at Monash U–there remain many ‘grey’ areas….and some foods we just have to trial cautiously.

I am impressed with your answers, you seem to have a great knowledge of FODMAP, and your willingness to share. I am a RD with years of hospital gastro training before beoming a private prac. dietitian. I March this year Sue Shepherd was i Denmark for a seminar, and I was very inspired by the FODMAP diet, so I started investigating and learning more. Now I am counseling in the diet, and with great results. FODMAP is new in Denmark, with som private hospitals doing counseling and a public hospital doing reasearch on the diet (sadly not the FODMAP content of foods) and counseling and then me. So every time I have questions I have difficulty in where to address them. And it is basically the same kind of questions as is asked on your page. The actual content in foods. Lactose, fructose (and partly polyols) is no problem (only that the different databases reports different values), but where do you find information abour fructan and galactan (gos) content? would be grateful for your help. Best regards

I hope these links work in Denmark….but they link you to the abstracts that provide the Monash University’s food analysis of FODMAPs with fructans and GOS (galactans no longer the term used) headed by Jane Muir.

I’ve beem studying the site; am just starting to work with fodmap, and was wondering if you know whether carob and camu camu are acceptable in small amounts? I try to avoid chocolate so knowing about carob would be helpful. Also, the camu camu as a natural vitamin C supplement seems to have some positive effects, and I’d like to keep using it if possible. I’m gathering my forces for doing the full elimination phase.

Mel, Coconut sugar has not been tested and I do wonder if it won’t make the low FODMAP ‘cut’ as it is a low glycemic sugar which makes me wonder if it is poorly absorbed and thus a food for bacteria. But I don’t know for sure….I have some that I am sending next month to the researchers at Monash in hope that it can be analyzed.
Miso is fermented soybeans so I don’t allow–likely source of galacto-oligosaccharides one of the FODMAP groups.
Glad you stopped by the blog!

Thank you Cyndi!
Chia and Flax seeds are allowed but limit to about 3/4 Tablespoon max per sitting to keep under FODMAP limit.
The Sugarfree Vanilla Coffeemate does not look like a major FODMAP source BUT it does contain sucrolose a sugar that I don’t recommend in general as it has been shown in one study to alter beneficial gut bacteria. Food products in general should be minimized for all of us as there are so many unknown additives to these types of ‘foods’!

Good to have you stop by Sharon! Thought about you today in fact
Collards and kale are okay…YAHOO!
Common cabbage made the okay list too! Surprisingly…
Savoy cabbage has been tested too and portion is limited to 1 cup. No word on napa cabbage, coconut sugar or spaghetti squash.

The Monash App should be out in about 2-3 weeks…they are working feverishly to get it to Apple–perhaps by Friday –then we will have access to lots more data…. I can’t wait to see this app in person.

Concentrated fruit such as dried fruit and jams are a bit tricky–as drying them concentrates the amount of fructose and/or other potential fodmaps. Small amounts of appropriate fruit such as dried cranberries are okay in a 1 Tablespoon or less portion from info I received from Monash recently. I have not seen any info on jams but would gather that a small amount (2 teaspoons) on a peanut butter and jelly sandwich would be okay but not globs of it. Of course, pay attention to other ingredients in a jam that would make it a no-no such as high fructose corn syrup or inulin/ chicory root extract or made from a fruit that is high in FODMAPs.

Hi Kate. I feel like I’ve researched the low FODMAP diet to death, but yet I’m still confused. I understand that HFCS is not allowed, but I see differing information about corn syrup and corn syrup solids. I was hoping that the FODMAP diet booklet from Australia would clarify this for me but unfortunately it did not. I saw in an earlier post that corn syrup solids are not allowed, but if that’s the case then why is Udi’s white bread recommended when it has corn syrup solids right in the ingredients list? I also don’t understand why brown sugar is OK if molasses is not. I would greatly appreciate any clarification you can give me. I have found your website and blog extremely helpful. Thank you.

Hi Leslie,
Unfortunately there are MANY grey areas with the low FODMAP diet–and that is because many food ingredients have not been tested so we rely on what info we can find in antiquated nutritional data bases. It’s frustrating for you and me…but it’s the nature of this diet until more food analysis is done. I allow corn syrup solids and corn syrup for now–but this could change as more corn syrups are tested. I have allowed brown sugar as Sue Shepherd allows it in her recipes and it appears to be well tolerated. Bottom line: Try your best to stick with whole foods that have been tested and food products that have minimal extraneous ingredients-at least for the first 2 weeks.

Thank you, Kate. By the way I am a fellow RD with 25 years of experience and I am new to this diet both personally and professionally. My question now is, how likely is it that the foods that I have been avoiding (resulting in me feeling much, much better!) will need to be avoided for life? I have followed this diet since 10/2/12 and the foods that I have challenged thus far (milk and wheat) have both been poorly tolerated. Are most people able to reincorporate many of the foods initially avoided, or do most stay on the diet indefinitely? Thank you in advance for your help.

Hi Leslie,
Tolerance to FODMAPs vary. From my experience working with many clients, most are able to tolerate some FODMAPs back into the diet. When challenging don’t go overboard, be sure to keep portions similar to what you might normally eat or even less, rather than try to push it.
Milk and wheat are common issues…did you try sourdough white bread or a 1/2 Bay’s English muffins or a handful of pretzels?
Many can tolerate the mannitol group–mushrooms or cauliflower.
And glad you are feeling much better…that is awesome!! Let me know if you have any other questions. And you should come to one of Patsy Catsos and my FODMAP workshops in 2013…for dietitians-one in Bridgeport, CT and another in Laurel MD! Very fun and interactive.

Thank you, Kate, and I will definitely attend your 2013 workshop in Bridgeport! If you already know the date I would love to know, otherwise I will watch for the information on your website. In the meantime, I will take it slow with the challenges and hope for the best! Happy Holidays!

Hi, Kate, I’m a bit confused about the 3rd edition safe foods. For example, your list still includes almonds and excludes lentils and raspberries, although the new app moves almonds to the “unsafe” and lentils and raspberries to the “safe” list. Is this a regional/variety difference? Thanks.

Rayna–I believe it’s due to more recent food analysis and updates. The raspberries, are likely okay–I kept on my list as high fructose due to US data but it is likely antiquated and so will be moving raspberries to safe list with my new updates. Almonds are low FODMAP if you limit to 10 nuts–if you look into almonds on the app you will see 20 nuts is high FODMAP and 10 okay. It’s a portion thing. The lentil info and chick pea info are completely new to me–I am learning about the updates as you are too!

Tom-
Unfortunately I can’t advise you on the tomatoes as your GI may have his own reasoning on that. Monash U allows tomatoes in small amounts. 4 cherry tomatoes for instance.
Fructose is a bit tricky. The low FODMAP diet excludes foods with more fructose compared to glucose in the food. The cut off is 0.2 grams excess fructose. I actually note the ‘cut off’ amounts on my check list. But there also seems to be tolerable amount of fructose even when it’s not in excess of glucose in a food– that individuals can handle–and that hasn’t been studied in the IBS population that I know of– For this reason, I encourage limiting to one fruit per sitting.
Make sense? It’s a bit of a tricky concept.

This is such a great resource–thank you. I am trying to find a good creamer that is low in FODMAPs. My favorite from previous experience is Silk Soy Creamer. The ingredients seem okay to me, but would love some feedback. The listed ingredients are: All Natural Soymilk (Filtered Water, Whole Soybeans), Palm Oil, All Natural Evaporated Cane Juice, Maltodextrin (from Corn), Soy Lecithin, Potassium Phosphate, Sodium Citrate, Tapioca Starch, Natural Flavors, Carrageenan.
Would this be acceptable? I would like to add a couple tablespoons to my morning smoothies and maybe a tablespoon to coffee.
Thank for the help!

Soy milk products made with whole soybeans would be a potential source of FODMAPs. So I would avoid this creamer while on the elimination phase of the diet. You could certainly try it as part of your challenge phase. Small amounts may be tolerated.

Typically Sprite would have high fructose corn syrup so it is not allowed on the diet. I discourage the use of packaged creamers–too many unknown ingredients. Why not add lactose free milk to a cup of coffee? The low FODMAP diet is not a dairy free diet but rather one that is low in the milk sugar, lactose. Hard cheeses are created in a way that the lactose is separated out from the protein portion of the milk and as such most cheeses are low in lactose. Wetter cheeses such as ricotta and cottage would still contain a fair amount of lactose so would not be allowed on the low FODMAP diet.

Juices tend to be a source of excess fructose and polyols so as a general rule they should be avoided on the elimination phase. Not sure what you mean by flavored water? Crystal light has Sucralose–which is not good in general for gut health so I would avoid. Water, lactose free milk, smoothies made with acceptable fruits and limits. lactose free milk or rice milk or lactose free yogurt such as Green Valley–would be healthiest choices.

Hi Ruth Anne,
I believe the di and mono glycerides would be okay–glycerin and glycerol may be a potential issue and it is difficult to see how these products break down in the body…but I think (operative word) that they would be okay.
The gums are not FODMAPs–again from what I understand–they are longer chain carbohydrates. Gums and pectins however can cause gas. So…my advice, see how you feel when you eat them… Package food in general is somewhat of a grey area…as not all of these food additives have been tested for FODMAP content. Whole foods –meats, acceptable produce and grains that have been tested should be the focus on the elimination phase -as much as possible.

Thank you so much for this information! I was recently diagnosed with Microscopic Colitis. The follow – up with my surgeon left me scratching my head. He prescribed Entocort which has helped a lot but after tapering I am starting to have effects show up again. Today was another followup but it was with a gasteroenterologist!!! I was ecstatic while visiting with him. He answered so many questions and gave me the information listed above. I will give this a try and hope my colon heals faster rather than slower. I need my life back.

Hi! I was wondering if you suggest any particular digestive enzyme that is FODMAP free? I take Natural Choice Products http://www.1inhealth.com/products/mde.htm
and was wondering what you think about the added ingredients for someone with frusctose malabsorption?

Not sure that product would be a great choice since it has beet fiber in it and beets are a moderate-high FODMAP food. Honestly most of my clients do not need digestive enzyme support so I rarely use them. Kirkman labs might be a good place to check out digestive enzyme products should you need them–here is a linkhttp://kirkmanlabs.com/ProductKirkman/90/1/Product%20Details/

Hi Kate, had an interesting encounter with a banana I thought worth sharing. I’m on a strict FODMAP diet and so I make sure I have only a small amount of safe fruit at any one time. I had 1/2 a ripe banana one day. The next day the remaining 1/2 banana had that REALLY ripe smell but I ate it anyway. Result – terrible gurgling tummy, pain, and 2hrs later a rush to the bathroom for a D attack and also painful urination (which is one of my symptoms the FODMAP diet has eradicated). Obviously the sugar in the over-ripe banana had morphed into enough fructose to make mer very sick. Sticking to firm bananas from now on!

Thanks for sharing Kaz. Certainly the amount of fructose–the fructose load could have been a potential trigger –but in some individuals it can be the amines in over ripe fruit that trigger GI issues. This area of nutrition is not well studied….but is interesting. Here is more info for those interested.http://www.sswahs.nsw.gov.au/rpa/allergy/resources/foodintol/salicylates.html
Another Australian institution that is paving the way in this area.

About the kale, I would agree that it is an IBS trigger because of the insoluble fiber. But trigger foods don’t necessary have to be high in FODMAPs. Fat can also be a trigger for IBS. (See Canadian research on “FOODMAPS”.) I do not tolerate raw kale at all, and I would eat small quantities only if very well cooked, which helps to break down the fiber. I do a lot better with cooked chard and spinach and raw baby spinach. Everybody’s different; go with what works for you.

Thanks for chiming in Rayna, I agree—the low FODMAP diet can be quite helpful for many with IBS but tolerance to fat, fiber, and other food constituents will vary from one person to another. I have some clients that can not tolerate dairy foods at all. They are not allergic to milk and it has nothing to do with lactose content–I think it might have to do with the opiate like chemicals in dairy that slow the bowel down–not a good thing for some with IBS-C. And on the other hand, many individuals tolerate lactose free dairy and some can tolerate dairy in any shape or form. Bottom line, may close attention to YOUR body and do what works for you.

I like two books that are specific for the low FODMAP diet-my colleague Patsy Catsos has a very easy to follow low FODMAP diet book, IBS free at last–check it out at http://www.ibsfree.net I also love Sue Shepherd and Peter Gibson’s book called the Food Intolerance Management Plan–great recipes and review of the diet. My book, The Complete Idiot’s Guide to Eating Well with IBS is a basic overview of IBS with an introduction to FODMAPs included.

I like both the booklet and Sue Shepherd’s book,The Food Intolerance Management Plan. The Monash booklet has more up to date info on foods allowed but Sue’s book has fabulous recipes and additional info. Tough call–I like them both for difference reasons.

The rice syrup looks low FODMAP to me. The fructose is low and there is more glucose than fructose which is key.

NO…but some are VERY easily modified–see below. My book was written in 2009 and was published in 2010–the diet has changed quite a bit since then–and continues to evolve. Many of the recipes are modified in FODMAPs however. Of note, garlic/onion salt/powder was considered okay back when I wrote the book. But if you simply sub in sea salt, sliced scallions (green part only) or a drizzle of garlic infused oil–they are perfectly low FODMAP! For instance, The cheesy dill dip, black olive tapenade, bruschetta spread, Tomato Salsa, Kevin’s Mini Beef Kabobs, Heavenly Halibut, Patrick’s Famous Quick-Fix Salmon, Burgers to Beat the band, Grilled Pork Tenderloin, Alfredo Pasta with Shrimp and Spinach, Our favorite Tomato Basil Pasta, Roasted Vegetables to name a few…are all low FODMAP if you don’t add the garlic/onion powder/salt (how easy is that!).
The other great news…is that I am working on a cookbook that will be ready to download in the next month! I am very excited about this project. Also, check my recipe page for current low FODMAP recipes to try. http://blog.katescarlata.com/fodmaps/

I see there is an app for Iphone. I have an androidphone and hope the app will be available soon. Thus the app contains the same info as the booklet?
I ordered allready the other books. Hope they arrive soon.
Is maltose a bad of a good sweetener?
I underweight and the doctor proposed me to take Fantomalt (a supplement of glucose). I seem to have a lot of abdominal pains, is it possible it’s because of this supplement?

Is the supplement you are taking maltodextrin? Technically that should not pose a problem….but these manufactured products have some variables. For instance, in a study done by the Monash team looking at enteral formulas used in tube feedings–the ingredients on the label did not appear to contain FODMAPs but when they analyzed the products they did in fact have FODMAPs. Relying on some package items is okay–but this should not be a staple in the diet. REAL food first when possible to increase calories is what I like to encourage–less variables—I trust Mother Nature more than product manufacturers. How about simple maple syrup?

I am so thankful I have found your website. I have been studying it for a couple of hours. I am going in for a Fructose Malabsorption Breath Test at the end of February. One of my questions is… Should I be eating foods that contain FODMAPS to help the test be more accurate? I’m thinking about the Gluten test, and I know that in order for it to be more accurate, you have to be eating gluten containing foods prior to the test. I really don’t want to add the FODMAPS foods back in, but I will if it will make the test more accurate. Do you know of a reliable nutritionist that is up on the latest info. dealing with the FODMAPS diet in Georgia? I’m excited that we may have an answer to a lot of my health issues, but also a little nervous about taking so many foods out of my diet. I do not do well with meat, and have a very hard time digesting it. This will be a journey for sure. Thanks again for all you do <3

To the best of my knowledge, there is no need to add back fructose containing foods prior to testing. I don’t know of a dietitian in Georgia that is knowledgeable in FODMAPs. It’s interesting you have difficulty digesting meat–is it the same for fish and lean chicken? Sometimes the higher fat meats are a challenge and may be due to issues digesting fat. Fat impacts IBS for various reasons. Fat stimulates the gut to move–which can be an issue for those with diarrhea. Also, some individuals have insufficient release of pancreatic enzymes so need to take supplements to break down the fat and I see numerous patients with fat malabsorption due to small intestinal bacterial overgrowth. (SIBO) Bacteria in the small intestinal can make your bile ineffective. Bile’s job is to help your body digest fats by making them into ‘digestible pieces.’ In SIBO, the bacteria make bile inactive. Bile is like ‘Dawn’ dishwashing liquid! Breaks down the fat into smaller units. Just some other things to think about! Not to confuse you–or overwhelm you–but rather educate.:)

You ALL make my work have purpose and meaning. I know myself personally how difficult it is to live with digestive issues and no answers… Fortunately, I picked the right career many years ago that allowed me to find solutions sooner than later. I wish you success with the diet!

WOW, thank you so much for taking the time to write me back in great detail. I wish you were in Georgia so we could sit down and talk You know more than my doctors do, and you’re willing to think outside of the box. Thank you!!
Yes, I am definitely having a lot of things going on in my stomach and colon. I do have a really hard time digesting fats except coconut oil and grassfed butter. I seem to do o.k. with those. But fatty or fried foods seem to cause bloat and severe pain. I seem to do fine with fish and eggs, but it seems like when I eat chicken, even pasture raised chickens, my constipation gets worse, and I get a very strange thing going on with my feet. They hurt in a way I can’t really explain, maybe almost bruised or like they have gout (even though I don’t know what gout feels like). I have tried grass fed beef, bison, and I am about to experiment with deer. My constipation gets so much worse and I have stool that looks like ropes of undigested meats or something. Sorry if TMI, but maybe you have an idea of what it could be.
I have no problems with diarrhea, but chronic constipation. I have to drink bags and bags of Smooth Move to be able to go. I have also tried the high quality brands of Enzymes with the Ox Bile and high levels of the enzymes that help with fat and protein, but they don’t seem to work. I have been taking them for a few years, and yes, I have tried other brands.
I’m hoping that this Fructose test will give us some answers and maybe he will test me for some of the other things you have mentioned. Praying for answers. I don’t mind following a certain diet if I know I “need” to and that it will help me.
Again, thank you so much!!
Blessings,
Cathy

Cathy, I would really encourage you to be tested for small intestinal bacterial overgrowth. Be sure the test measures both hydrogen and methane gas. Constipation predominant IBSers tend to have more methane producing bacteria…methane makes the bowel sluggish. Treatment for SIBO is rifaximin–an antibiotic. Sometimes the docs will add neomycin for people that are constipation predominant. On a side note, I lived in Georgia for 2 1/2 years while I attended Emory U in Atlanta–I ended up transferring out when I decided I wanted to be a dietitian. Too bad I wasn’t still there.:) I certainly like the weather better than the cold of Boston!!
The chicken reaction is interesting. You don’t have tingling sessions do you? Have you had your B12 level checked?

Mayo should be okay…but check ingredients to be sure-mostly eggs and oil–which don’t have FODMAPs. Soy sauce is low FODMAP–though it contains wheat it is in very small amounts– not enough to pose a prob. Most vinegars should be okay but Balsamic vinegar should be limited to 1 Tablespoon per sitting and I imagine apple cider vinegar as well….but I have not seen any data from Monash on apple cider vinegar.

Hi Kate. I seem to be unable to tolerate oats, even though they are on all of the low FODMAP lists. I have tried them several times, always with the same results. Have you ever heard of this before? Thanks!

Yes, I have Leslie. Some individuals can’t tolerate oats. This could be for a number of reasons. Oats contain saponins which can increase intestinal permeability also known as leaky gut. Or, perhaps its a gluten issue as oats often contain gluten due to cross contamination in the fields or in the processing –Have you tried gluten free oats? Or perhaps due to lack of digestive enzymes that break apart starches in the intestine. FODMAPs is one piece of digestive health for IBS and an important one. But we are all a little different so may need additional dietary modifications.

Could you say a little more about the digestive enzyme issue and how that plays a role in symptoms? How would someone know if this was a problem for them? What foods could be triggers: just starch, or anything? Thanks!

Cory, in some individuals the enzyme–sucrase-isomaltase production is minimized and this can impact digestion–but is thought to be rare. I am not an expert in this (disclaimer!) but I do like to research anything to do with digestive health… To determine if production is low–this can be done with a small intestinal biopsy and I believe a breath test too can be used to evaluate this disorder.

I’m very surprised that bananas are on the FODMAP friendly list since they contain inulin. Inulin, from everything I’ve read, is definitely on the do not eat list! I’ve been on the FODMAP plan for a couple of years now with pretty good success, however I still have bad days form time to time. I discovered bananas had inulin in them myself when I kept having trouble every time I had a banana. I couldn’t figure out why until I was doing a search one day on inulin on the web. I discovered from info on the web that inulin is in bananas. BINGO! It immediately got my attention! That’s why I shouldn’t be eating bananas! Why is it on the friendly list? Does anyone else have a problem with bananas?

Staying on the FODMAP plan keeps me gas and bloating free, but I always have hard stools that are painful to pass and is accompanied with a yellowish, acrid mucus that seeps out at any time. I have been able to help the hard stools with taking Miralax regularly, but the mucus is something I always have to be prepared for by wearing light pads most of the time. What do you suppose that’s all about? Do you know of a Dietitian in the Bridgeport, CT area that could help me? I know you’re having something going on for dietitians on April 5th in Bridgeport, but not being a dietician I can’t go. Too bad! Would love to be there.

Thank you for all the help you give to everyone. You are a blessing to many!

Diane, I would wonder about inflammatory bowel disease with your symptoms–so consider following up with your doctor.
The Monash team have tested bananas and have allowed them on the diet. I know there is info online that suggests they may be a trigger or contain inulin but many of my clients tolerate them without an issue. After the Bridgeport workshop, there will be several RDs in the area that will be educated on the diet–so follow up with Patsy Catsos’ RD list on IBSfree.net when looking for a dietitian to work with. She will likely have RDs add their name to her registry.

Do you know Kalisse Wood /Glycyrrhiza glabra? Is it fodmapfriendly? When I have gastritis, I feel much better when I “eat” them. It taste quiet sweet, so I doubt it’s fodmad friendly?

I am so confused about all the sweeteners. Maple syrup is ok. My RD says to use aspartame, but I read lot’s of bad things about this (cancer,…).
Table sugar can be used in very small amounts I suppose? What about cane sugar, icing sugar?

In Belgium there is almost no knowledge about the fodmapdiet. The RD and doctors asked me for “testing” the diet.
I am so happy with your blog, it helps me a lot!!! I want to start my own Dutch blog to help other people and to share our experiences.

I am not a fan of artificial sweeteners so to add a hint of sweetness try a drizzle of maple syrup or cane sugar. Icing sugar is fine too. And you should write a blog and help others in Belgium. I don’t know anything about Kalisse Wood/Glycyrrhiza glabra.

Passing mucus in the stool is not harmful in and of itself, but it could be a symptom of a disease or condition that may require treatment. It can be found in IBS but is also seen with infections and inflammatory bowel disease and should be evaluated by a doctor.

Hey! Great site.
Do you have any ideas around the safety of taking echinacea, licorice or vitamin c? I’m finding when I get a cold and take anything with immune boosting ingredients, although being careful, I’m getting IBS symptoms. Mostly gas. Just wondering if it could be the amount of vitamin c tablets or something in the ease-a-cold (an australian natural medication based around echniacea)

Hi Katie–It could be the Vitamin C which can contribute to diarrhea not sure about gas– if you want to send ingredients in the products you are using I can try to help decipher them. Not sure about echinacea.

Alexandra–I am not sure about turnip leaves–if I had to guess, I would think they would be low FODMAP and common cabbage is the smooth round green cabbage–not sure about the purple–yes, often used in coleslaw.

I make my own bread with a mix of different flours.
I use 1/4 buckwheat or rice flour and 3/4 spelt flour (100% spelt, wheat free). Is this ok, or do I have to try to make it without speltflour? When I only use buckwheat or rice flour my bread is flat.

Spelt has been tested at Monash and found to be low FODMAP–but spelt can be cross contaminated in the field so it may be that some spelt flours are better tolerated than others. I would give it a try in your bread. Most gluten free grains seem to be lower in FODMAPs so perhaps give teff a try. I have not seen any published data on teff so can’t tell you for certain if it is low in FODMAPs.

Do you know something about the results of the breath tests. I did the test for fructose in a hospital. My result was 137. The doctor says to limit my fruit intake, he didn’t talked about the FODMAP. Another doctor told me to follow the fodmap, but he couldn’t give me a dietician specializing in the diet. In Belgium they are just introducing the diet, which make it difficult for me.
My dietician said I’d better do not eat fruit. I avoid fruit but I miss it a lot and I hope to introduce it again without lot’s of problems.
Yesterday I ate carrots and I felt very bad. Lot’s of flatulance and convulsions. Is it possible that carrots contain to much fructose?

I purchased the fodmap app and it has helped me greatly; I recommend it to everyone trying the fodmap diet, it will make your life a lot easier!
However, I did not find any info on pectin. I live in Canada and the only lactose free yogourt I can find contains pectin; is that low or high fodmap??
thanks!!!

Hi Kate. All of your information on here has done wonders for me so far.

I was wondering if you could tell me what you know about coffee that is infused with flavour.
I usually just buy Moccona instant coffee but by mistake, picked up the caramel infused version. Would this be ok to have for the low FODMAP plan? I don’t want to set myself back to square one if I have it!

As the challenge foods. Are these the best ones to use? And would I do it on an empty stomach in the morning, and only be eating rice the rest of the day and monitoring symptoms for three days right? Thing is I find milk extremely disgusting for one, I am not sure if I can manage it! Is there an alternative testing thing for lactose, or is that really best? And is it in fact easy to notice and monitor symptoms, or is it often very small mild reactions you get upon challenging it? Thankyou!

Ellie, Perhaps try 6-8 ounces of yogurt for the lactose challenge. When challenging foods, its best to trial them on your low FODMAP diet. No need to just eat rice. The challenge foods selected are key foods as they contain only that FODMAP (although beans have a combo of Fructans and GOS (galactans). ) Testing for fructose malabsorption would not be undertaken with an apple as it contains other FODMAPs such as sorbitol and it would be difficult to figure out which FODMAP group was an issue for you. As a reminder the low FODMAP diet is best undertaken with the help of a knowledgable dietitian whenever possible.

I would have a dietician if I were in the UK currently, but I am in Germany and also very poor. I have just challenged the Fructans with white bread and I am finding quite the reaction; is the best way to go ahead, to wait two weeks till symptoms are definitely back to normal, and then challenge the same food again? How many times should I challenge a problematic food product? I have been eating low fodmaps very strictly for 6 weeks, trying to keep it nutritional though. I had the bread late afternoon, and this morning I still have tummy rumblings, which seems to be as a definite thing to continue cutting out a while. Post challenging food groups, do I challenge individual foods, eg. onions, in the same way? Thanks for being my online resource! I don’t think FODMAPS is even a thing here yet, even if I could get a dietician..

Ellie, Certainly let you body calm down and be symptom free for at least 3 days before undergoing another challenge. I have yet to have a client pass the onion challenge –but its worth a try. 1 TB of onion is a good portion to rechallenge with. I would hold off on the bread challenge for a while –a few months perhaps and then you could re-try it. You don’t want to keep aggravating your symptoms.

Also, in paying so much attention to my own body – am naturally keeping a diary of reactions during challenge phase – it has been snidely pointed out to me that I may in fact have more of a reaction if I am focusing so much on it, which is a sort of catch 22 situation as you need to note the reaction! So it is probably best to try challenge it a few times? I found I mainly got a lot of trapped gas for both ends and stabby stomach and some bloating. I am not sure if my body could simulate the gas in a sort of way of expecting a reaction?? Sorry this is so odd to ask!

Ok, and to clarify, TB is Tablespoon right? I think this challenge yesterday has made me realise how much the low fodmaps helps! I mean I noticed a big improvement, with a few occassional issues still (perhaps even normal gut feelings, who knows!) but I actually realised what it had been like pre-FODMAPs, and I am glad, as it will make me continue as strictly as I have been going! I was worried after inviting foods back in, that the difference would not be big enough for me to get back on the FODMAP wagon. Thank you for your support!

Hi Jude- I think reducing raw veggies can be helpful for some people–but not all. From my experience, those with IBS-D tend to have more trouble with raw veggies–but again this is variable. I think the pain is often due to the distention from gas and trapping of gas and fluid due to the abnormal motility pattern of the IBS intestine….and the low FODMAP diet seems to really help with this. And thanks for your kind words…I do try my best to keep up with all the queries and answer to the best of my knowledge

Bernadette, The Monash University app has common cabbage (the smooth green skin) as allowable at a 1 cup serving. Savoy Cabbage, however, should be limited to 1/2 cup per serving. YUP, yay for cabbage. AND, my clients that have tried it…tolerated it well!

Great, I haven’t been more excited than when they listed broccoli as suitable in small amounts (when I was diagnosed it was a nono). I wasn’t going to bother getting the app because I thought I was pretty up to date with the research but I think I will now

Bernadette, the best part of the app is its always with me. Even though I live, breath and eat low FODMAP–sometimes I might forget a portion size or some of the red light foods. It’s so nice to have the app at my fingertips!

I want to buy some glutenfree bread but I found it hard to find a suitable one. I saw one that seems to be ok, except 1 ingredient I doubt about. It contains sweet lupine flour. Is this a problem? It was at the end of the list of ingredients.

I have come to love Udi’s white bread as well, but I have three questions related to this bread: Why is the recommendation always for the white and not the whole grain? Is it the presence of dry molasses in the whole grain? Why does the bread not appear to be dated? (tough to know how long it’s been sitting in the back of the freezer at the grocery store). And any idea why the slices are so small?? Thanks!

The molasses may be a source of excess fructose so that is why I don’t initially recommend the whole grain. BUT many of my clients have been able to incorporate the whole grain Udi’s so perhaps its not too big a dose. Not sure about the dating on the bread–I have not noticed this. I would contact Udi’s–and when and if you do, encourage them to stop changing their ingredients…another issue that has come up recently! ALWAYS re-check ingredients on manufactured goods!

Hi! I have lived with IBS for 20 years. It is just a part of my life. I am uncomfortable at all times. But, most people don’t know because I smile and pretend I am not living with it. I am new to the low fod-map diet and I love cheese and chocolate. I have lots of questions, but can not find any information about laughing cow cheese. Is this allowed? Do I have to watch every item that has dairy in the ingredients, like protein powder? Thank you for this website. It is the best I have found online. I am determined to follow the diet and make positive changes to the way I feel. Thank you!

The low FODMAP diet is not a dairy free diet but rather low in Lactose. Laughing cow cheese should be okay from a lactose stand point–just don’t pick the ones with onion and garlic. Chocolate has not been officially tested for FODMAPs but I do allow my clients to have semi-sweet chocolate chips and they do not seem to have a problem.

I’ve been on the FODMAP and also gluten free diet for over a year now and also eat Udi’s bread. It’s the best gluten free bread that I’ve been able to find. I really like it! The whole grain is what I get and is the best for me, since there’s inulin in the other. I can’t tolerate inulin. I’d rather have whole grain anyway since it should be healthier for you.

I also buy the whole grain and not the white. I know it goes old, I did not eat the last loaf fast enough and it did get mold on it. The calories are low for 2 slices of bread and yes it is smaller. I load mine with veggies and toast it to use as bread crumbs on salads for that crunch that I love in a salad. It is very good with laughing cow cheese. Enjoy!

I’m reading the ingredients list on the Udi’s White sandwich bread now…no mention of inulin on the label. I keep my loaf in the freezer. The slices pull apart easily when I want 1 or 2 of them for toast or a sandwich.

I may be wrong, but I think the difference between the Udi’s white and whole grain breads is not that one has white rice flour and the other has whole grain rice flour. They both have brown rice flour, but the “whole grain” bread also has teff flour.

Hi Kate. What are your thoughts about sorbitol-containing toothpastes? I am obviously not swallowing my toothpaste, but I am extremely sorbitol sensitive and wondered if I should be concerned about this. Thank you!

I don’t have a smartphone, so no apps for me, but I noticed that, for instance with tomatoes, the above pdf just lists them as OK, but you responded to another poster that Monash app only recommends them in very small quantites, such as 4 cherry tomatoes. However, I love veggies in generous quantities. Are there any that can be eaten in large quantities, or should even the ones on the safe list be limited?

Helena-this is a GREAT question!! Unfortunately I can’t give you a definitive answer as much of the data on food analysis is not published yet. The app has foods put in portions but some of them are less than what technically should be the cut off for the food. For instance the app lists 4 baby spinach leaves as the cut off but then notes that likely more will be tolerated in the information listed about spinach. So…I think to make a general rule–I would not eat HUGE quantities of veggies as it would be easy to consume too many fructans/GOS. Kale and arugula have the largest serving size==1 cup– that I noticed so perhaps make a nice salad of either as a ‘filler uper’

I’m with Helena. I was raised by a gardener, with fresh vegetables available all summer long. I was one of those odd kids who always loved broccoli, asparagus, Brussels sprouts, salads, you name it. Some days I crave a plateful of SOMETHING fresh.

I know how you feel. Summer and the farmers’ market are depressing to me now. I often think my diet includes less “healthful” foods now just to keep my gut from making me crazy. In the midst of summer, sometimes I will just go ahead and eat something like a really fragrant piece of fruit to remind me that the few minutes of enjoyment are not worth the two days of suffering. Other times I can eat a small amount of something and avoid all other moderate to high FODMAP foods that day and get away with it.

A farmer’s market still has so many yummy and healthy low FODMAP foods. Some foods need to be kept at smaller portions but many can be enjoyed….think zucchini, tomato, summer squash, eggplant, blueberries, strawberries, salad greens, fresh herbs, kale–I like to think of what I CAN enjoy without pain rather than what troubles my gut!

Not sure if Ecomil quinoa milk would be okay. I haven’t seen any official data on quinoa milk. Are you trying rice milk or is it another product. Plain rice milk should not pose a problem from a FODMAP standpoint. Perhaps something else is triggering your symptoms?

I tried it allready several times, and each time I had pain and bloating. I ate it with foods listed on the elimination diet phase from Patsy Catsos (non bold food only, so I suppose safe foods), I took only 1/2 cup.

Hi. have done more than 3 weeks on the elimination diet and am doing it SO strictly. The most pain free days were 5 in a row. I still have so many painful days/bloating etc and am wondering if I just need to persevere with the diet. Or are there other foods not on FODMAP that also need to be eliminated?

Mary, You can take probiotics while on the low FODMAP diet but its not really recommended to start both probiotics and the diet at the same time as you would not know if the diet or the probiotics were helping you. So try to keep to one change at a time. Also, choosing the right probiotic without FODMAP ingredients might be helpful as well. FOS or inulin are often added to probiotics as a source of pre-biotics but they are sources of fructans (FODMAPs) so choose probiotics without those added.

I’ve just started the diet, so I am having a bit of a hard time putting a dish together that pleases my tastebuds. Are sundried tomatoes fine by any chance ?
I know tomatoes are, but tomatoe paste isn’t and dried fruit aren`t , so I`m a bit unsure what category sundried tomatoes would be in ?

Thanks from France – Land where nearly noone has heard about Fodmaps yet !

Well good news Anja my new cookbook–downloadable– it up on my website for purchase–perhaps you will find some fun recipes! Here is the link to the cookbook! http://www.katescarlata.com/fodmap.htm Very small amounts of sun dried tomatoes are okay–1 Tablespoon to be exact! Otherwise more than that can be a source of excess fructose. And glad you found me in France—Paris is one of my favorite places in the world!

i started the fodmap diet and my main symptom is gas no stomach pain some days are better than others.peppermint I’ve been told is okay what about fennel tea? do i have to go gluten free or wheat free? i’m a little confused?

Hi Linda, the low FODMAP diet is mostly wheat free–it is not a gluten free diet per se. FODMAPs are carbohydrates and gluten is protein. But there is some overlap as both diets modify wheat, barley and rye. Fennel tea should be fine as fennel leaves and fennel bulb are both low FODMAP. Check for other ingredients in the tea to be sure.

thanks for clearing this up would french bread be allowed? i”ve read that it should be. another ? is karo syrup a low fodmap? i know high fructose corn syrup is not allowed arent they the same? what about karo syrup solids?

Hi Linda, French bread would be a source of wheat and not allowed on the elimination phase. Corn syrup and corn syrup solids should be low FODMAP–however, I would love to have some of these syrups tested as I do wonder if some brands may have some FODMAPs. But for now, I do allow them with my clients.

Kris–I recommend sticking with water or seltzer (if you can stand the bubbles.) You could add plain cranberry juice–made without high fructose corn syrup–a splash (1/3 cup) with a lime wedge to add some flavor. Soda made with real sugar could be too much of a fructose load so I don’t encourage it. And I am not a fan of fake sugars. Gatorade has a G series Perform 02 thirst quencher made with sugar and dextrose that should be well tolerated–perhaps in a 6 ounce portion.

I do okay with Kool-Aid made with half cup sugar and half teaspoon pure stevia extract (powder form) (not Truvia with those -tol sweeteners added). I store it in the frig this way. To drink, I water it down to 50%. The lemonade flavor is too acidic for me. Grape and watermelon kiwi (artificially flavored watermelon, plus this flavor has no food coloring) are my favorites.

Also, I forgot to mention Celestial Seasonings Green Tea Decaf Mint and Tension Tamer make super iced teas. The Tension Tamer is really refreshing but bothers me if I have more than one glass, probably due to the chamomile. (All chamomile tea makes me queasy, but I have pretty bad seasonal allergies.) Hope this helps!

Hello. I have severe IBS and have followed many diets without results. How long should I follow the FODMAP diet if I don’t see results? In other words, how long does it take for this diet to show results?

One reason I’m asking is that I once did a 17-day cleanse of just hot water mixed with lemon juice, maple syrup, and cayenne. So I guess I wasn’t consuming any FODMAPs, and I was still experiencing IBS.

It sounds to me Claire that the low FODMAP might not offer relief if you did a 17 day cleanse with low FODMAP ingredients and still did not feel well….however, I do wonder how anyone could exist off maple syrup and lemon juice. I hope you work closely with your doctor and dietitian to find help for your ongoing IBS.

Spicy foods make my IBS flare as well as moderate to large quantities of fat and insoluble fiber, caffeine, carbonation, and acidic foods like coffee. Some people also have problems with strong peppermints. The primary differences I notice with the low-FODMAP diet are less gas and relief from nausea and bloating. Other triggers have more influence on the bathroom issues for me. I would recommend still giving the low-FODMAP diet a try for at least 3-4 weeks, and see whether specific symptoms improve. Just be aware you may have additional triggers, in which case your diet will need fine-tuning.

Totally agree with Rayna, I have the same benefits and have really noticed the difference after my very lax week post challenging wheat and dairy, where I then ate lots because I had challenged it and just was greedy; I definitely should not have wheat.

And in any case, only having lemon juice and maple syrup in your stomach will just make your stomach stressed in any case, ibs or not. I have also heard (and sort of found), small regular meals are beneficial for ibs. Overeating or skipping meals infuriates the stomach in any case.

Hi Kate,
Thanks very much for your help.
I used to have IBS-D almost exclusively for many years, including foggy brain etc. Since following Low Fodmap for the last couple of years foggy-brain, tirdness has improved alot but IBS-C has replaced it!
My question is about fibre, is it good or bad?
Things seemed to have gotten worse with constipation rather than better after increasing fibre intake (mainly with oats).
Main question being: Is more soluable fibre generally a friend or enemy of IBS-C?

Paul, So glad that many of your IBS-D symptoms along with tiredness and foggy brain have gone away. It is not uncommon in my experience for constipation to occur on the low FODMAP diet if you are not careful to add in enough low FODMAP fiber sources. To me, its not so much an issue of soluble vs. insoluble fiber but trying to find low FODMAP sources to meet your needs. Oats have fructans and GOS (FODMAPs) in servings >1/2 cup cooked. So if you up the amount too much it may trigger your symptoms. Perhaps try rice bran, oat bran, chia seeds to meet your fiber goals. Chia seeds have 5 grams of fiber per tablespoon are low FODMAP AND seem to be tolerated by many if not all of my clients. I have provided a link to a fiber info on my blog to help you a bit…but as always, I recommend working with a health professional when changing your diet. http://blog.katescarlata.com/fodmaps-basics/fiber-without-fodmaps/

No onion juice or garlic juice would not be good options on the low FODMAP diet. Perhaps try chives or green part is spring onion for onion flavor and for garlic- sauté garlic in olive oil remove garlic and flavor foods with the infused garlic oil.

Hi Kim, different corn products yield different amount of FODMAPs. 1/2 cob of corn okay so I would assume a typical popcorn serving should be okay too. Corn tortillas have not been tested. I would imagine these might be restricted in large amounts–but more to come on that. Corn flours have been tested and are low FODMAP so I am thinking that corn pasta should be low FODMAP too.

Hi !
Im a HUGE Starbucks fan and as I’m sure you know, they only offer regular cow and soy milk. I’m not willing to give up my Starbucks, but since soy and milk are both on the list of things to avoid.. which one is better and will cause less symptoms? Thanks!

Oh Cassidy, I am a big Starbucks fan too! I would say, use a splash of whole milk vs. the soy (which seems to be a bigger trigger for many of my clients)–OR better yet bring some lactose free milk in the car with you and use it instead!

Good point Rayna–in a pinch the lactaid fast act pills are a good low FOdMAP source of the enzyme lactase. Typically during the elimination phase I recommend avoiding high lactose containing foods as possible and then after the elimination phase perhaps try the enzyme pills–just to try to do the diet as cleanly as possible. But when you don’t have an option and milk is on the menu–it’s a great plan to try the lactaid fast act enzymes.

hi Kate I live in United Kingdom, firstly I want to tell you the fod map diet is amazing! it has saved me from major bowel surgery.Thank you so much! I’ve been so ill for the past three years. Doctors thought I had a prolapse and I was facing a permanent ileostomy and it was just wind! I have a bowel condition its called an ileo anal pouch I have no colon just small intestine,the pouch is my small intestine turned inside out I go to the toilet normally, just a lot, I just want to ask you is vsl#3 a probotic that my doctor prescribes me for pouchitus (a nasty inflamtion in the pouch that can occur from time to time)fod map friendly? also can you recommend a daily probiotic that is fod map friendly please? thankyou

VSL# 3 is FODMAP friendly. I am not sure a daily probiotic is necessary for everyone. But when choosing a probiotic you might want to select one without prebiotics which are FODMAPs such as inulin or FOS.

Hi Kate,
I have a question about wheat and gluten free. If a person is following a low fodmaps diet, and they have issues with wheat (fructans) do they necessarily need to avoid gluten in all food products. I thought gluten only needed to be avoided for people with celiac. My son has had the blood test for celiac and that came back negative, but he does have the Big D from whole wheat or whole grain breads. I even bought some gluten free wheat bread, and he still had problems with it, so I know it’s not the gluten per say, but probably the fructan (fructose). Thus, I’m just double checking because alot of the foods you list as fodmop friendly say gluten free. Can you educate me a little on this subject matter please? Thanks you, as I have 2 children with GI issues and all your information is helping more than you will ever know!!

The low FODMAP diet is not a gluten free diet–but there is some overlap btw the diets as wheat, barley and rye are the sources of gluten in the diet and also contain FODMAPs-particularly fructans. Gluten is a protein and the low FODMAP diet focuses on carbohydrates, particularly small sugars and fibers. Small amounts of wheat can be included in the low FODMAP diet such as that found in soy sauce for instance while on a gluten free diet absolutely no wheat, barley and rye is allowed. Hope this helps.

Thanks Kate for the reply. While I have you on the line, do you have any recommendations for a line of chewable vitamins for kids that don’t have sugar alcohols and other fodmops. Then, the ones I find that are on the healthier side, tend to be made from a variety of fruit juices. Maybe I’m going overboard, and don’t need to be too concerned with this, since they only get 2 gummies a day, but wanted to get your professional advise. Oh, and what about liquid meds like IBprofen. HFCS is the first or second ingredient listed. Pharmacists have no clue and there is only one dietician in our state who is fodmap trained and this is at an adult clinic that doesn’t see kids. Ugghghh.

Deborah, Choose gummy multivitamins made primarily with glucose syrup. CVS and Trader Joe have varieties. The kids vitamins often do have some carrot and blueberry juice but I do allow and they seem to be tolerated. I would avoid the liquid advil/ibruprofen that have the sorbitol.

thanks for the help on my last question!
i have another one actually!
IBS causes both constipation and diarrhea depending on the person, correct?
does that mean some foods on the low fodmap diet make you go while others don’t? or do the foods affect both constipation and diarrhea depending on the patient? if that makes sense..
thank you!

Cassidy-how foods contribute to diarrhea vs. constipation is likely multifactorial…. food that is not adequately absorbed in the small intestine travels to the large intestine and is then fermented by bacteria –different bacteria produce different types of gas when they ferment food. Methane gas is associated with slowing down the bowel and more common in IBS-C while hydrogen gas seems to speed up the gut and is linked more with IBS-D. The longer the chain of carbohydrates found in the FODMAP the more water is drawn into the bowel but this does not necessarily mean you would definitely get diarrhea from the longer chain FODMAPs–it really depends on how fast your intestine moves, the type of bacteria you have in your intestine and probably many other factors. (all FODMAPs are small chain carbohydrates but the longer ones would be fructans and GOS and the smallest is fructose, a one ‘chain’ sugar.) Sorry for the science-talk!

Hi Diane, I don’t think these sugars would be a FODMAP issue. Honestly, I am not familiar with them as supplements. Raisins are not allowed on the elimination phase of the diet. Even though grapes are allowed on the low FODMAP diet–it seems when drying the grapes to create raisins the fructan content goes up!

A number of gluten-free breads at a local market look good except for one ingredient that I’m not sure about: glucone delta lactone (GDL). I suspect this may not be okay on low FODMAP elimination phase.

Hey Gary, Funny you should bring up GDL as I was just speaking to a colleague about its presence in bread products here in the US. It drives me a bit crazy that we rely on these types of ingredients instead of simply using real food. If I had to guess, I don’t think GDL would be a FODMAP. Here is a paper by the USDA with its description. Hope that helps.http://www.ams.usda.gov/AMSv1.0/getfile?dDocName=STELPRDC5067074

One of my biggest pet peeves about the US food supply is our commercial bread…of course, there are so many things about our food that trouble me…but that’s a story for another day! I truly get frustrated walking through the bread aisle at a conventional grocery store. I end up getting bakery made bread–sourdough varieties with recognizable ingredients- which I thankfully can tolerate. I haven’t explored making GF bread on my own, but King Arthur flour site has some GF recipes to try.

Thanks for that, Kate. I agree with your pet peeve: out here (Santa Cruz area), we have tons of gluten-free products available, many breads and related things, but almost all of them have inulin or agave in them, and then most of the remaining few have GDL. I must say that brown rice tortillas have become my go-to store-bought “sandwich wrapper,” though i’d sure like some variety

I’m also now seeing Teff flour, which is supposedly gluten-free, but I don’t know if it’s low fodmap.

From the research I have read, both ripe and firm bananas should be okay…The carbohydrates do change (fructose and glucose increase with ripening) but both states of ripeness do not have EXCESS fructose which is key.

Hi Kate,
It is nice to hear your frustration as well with all the “extra” foreign ingredients put into bread and baked items as a whole. Even in the bakery at traditional grocery stores, a cake, muffin, ect there are like 20 ingredients added to them. What ever happened to flour, eggs, oil, table sugar, vanilla, baking soda and or baking powder and salt. That’s all that should be in the base ingredients for the majority of these items. Thus, just better off making these items at home if you want to “treat” yourself.

Hey Kate,
Wow your blog is just great! Thanks so much
I have been suffering from IBS-C for 2 years following a bout of malaria. I often have bad flare-ups where I just don’t go for 3 weeks, and I am constantly bloated.. . I look 6 months pregnant! I am slim so it really stands out.
Anyway, I think this will diet will really help and
I started last week. Unfortunately I gave in to a choc ice and have felt terrible for days.

I have a questions about oats (porridge). I have porridge for breakfast every morning and I thought this was fine. Not gluten free, just your plain supermarket oats. I read further up that >1/2 cup cooked oats is too much. Does this mean that my 40g serving (approx 1/4 cup dry before cooked with water) is too much?
Also I am confused about golden syrup. I normally have 1 tea spoon on my porridge. Is this ok?
Also looking for an alternative to milk and a little confused about almond milk. How much of a serving would be ok?
Thanks so much
Emma

Hey Emma–Glad you stopped by. 1/4 cup dry oats is okay but no more than that as then you venture into ‘too much FODMAP’ category. Golden syrup is okay–small amounts of course-a teaspoon or two. Almond milk is officially being tested now…so the not sure if it’s okay. More to come on that! Be sure with IBS-C that you get plenty of fiber and fluids (water primarily).

Hi Kate,
Thanks for the immediate response! That will really help with shopping tomorrow (a now highly stressful task). I only have a bit of milk on top of porridge – could this be ok? If not then I will get another alternative.
If it’s ok,I have a question about spelt bread. When I first found that I was so excited about baking some bread – I can get wholemeal spelt flour no problem. I am now confused whether this is ok. Would two slices of homemade spelt bread (http://www.dovesfarm.co.uk/recipes/spelt-bread/) be ok or not?
Thanks so much. I am going it alone as it will be 2 months before I can get help from a dietitian. I know that’s not great but tired of feeling so bad I’m 27 and should be in the prime of life but instead can’t do anything
Emma

Hi Emma-
I would suggest you try coconut milk or lactose free milk for now and avoid the almond milk to be sure you are not getting FODMAPs. The spelt bread should be okay to try. Purchase 100% spelt flour. Growing conditions do impact spelt FODMAP content so the Monash team will be testing spelt breads from various countries to verify that all are low FODMAP not just the Australian spelt breads. But this project will take some time and I have had clients try US spelt bread without issue. Feel better. I hope the diet makes a difference for you!

Hi Kate,
Thanks so much for the help, I will do all of that.
I am sorry, I have thought of one more question that I think you can help with. I am not sure if my morning breakfast is causing a problem or if it is because I have bad C at the moment and so getting full is really the problem. My tummy is quite gurgly in the morning after breakfast. I am wondering if I am having a cumulative effect of FODMAPS? Perhaps you could tell me. I have:
– 40g oats cooked in water
– sprinkled with 1 handful cornflakes
– sprinkled with 1 round tea spoon flax seeds
– 1 tea spoon golden syrup
– 1 square dark chocolate
washed down with a glass of water and a cup of herbal tea/cocoa (just 1 tsp cocoa with hot water, nothing else). Oh I miss coffee so much and not sure about it! Maybe it would help me go?

Sorry to ask so many questions, I just have no access to help at the mo but really want to try this.
Thanks
Emma

NO worrries Emma. I don’t think that breakfast should be too much of a problem–seems fairly low FODMAP. Sometimes a cup of coffee can get the intestine moving a bit in the morning –especially combined with light exercise.

Portion sizes vary for fruit and veggie FODMAP cut offs. The Monash low FODMAP diet app is useful in this way–download it if you can. But if you can’t get the app, would suggest 1/2 cup fruit -low FODMAP choices or 1 medium orange, banana per meal–this if very rough estimate. Veggies are very variable–just try not to go overboard and ‘balance your plate’ with protein-lean meats, chicken, fish or tofu, healthy fats, fruits and veggies.

Hi Kate, I wondered if you could give me any advice on soy products. I live in the UK and I saw on your site that Alpro soya milk products are suitable on the FODMAPs elimination diet – do you know if this is still the case? I also like Cheezly, which is a dairy-free cheese with the following ingredients: Water, potato starch, non-hydrogenated vegetable fats & oils, soya protein, yeast extract, thickener: carrageenan, salt, natural flavouring, calcium phosphate, acidity regulator: sodium citrate, natural colour: carotene. Do you think soy protein is suitable for re elimination diet? Many thanks for your help.

I believe that is still the case on Alpro soya milk–the key is that the ingredients read, soy protein NOT whole soy bean. The Cheezly seems that it would be lower in GOS as well as the ingredients refer to soy protein NOT the whole soy bean. As for your question below, I am not sure about coconut flour –I have not seen any data on it. It is SO high in fiber so I am concerned it might be a FODMAP issue.

I noticed further up in the comments that the serving size of oatmeal to remain low FODMAPs is 1/4 cup (dry). I usually have 1/2 cup (dry) serving for breakfast mixed with rice milk and water, so to minimise FODMAP overload, would my breakfast still be considered low in FODMAPs if I mixed it with another grain, like 1/4 cup dry serving of buckwheat flakes, or even 1/4 cup of dry serving oat bran or rice bran? Would mixing oats with oat bran be OK?

I would try to keep the other grains very low in FODMAPs perhaps a brown rice flake and you might be okay to add a tablespoon or 2 of oat bran as well but like oats, oat bran also has fructans and GOS. Much of the data on grains remains unpublished so requires some well educated quesses. With that, I think that the cream of buckwheat might work as well.

I have done Low FODMAP for a week now…and I am NOT using any dairy at this time. If I do..it’s lactose free only…right?
And am the only that seems to have trouble will AL FRUIT? The belching and abdomen pain and bloating happen within 2hrs….

Laura- have you been tested for small intestinal bacterial overgrowth. I am suspicious that your symptoms reflect this may be an issue for you. Low lactose cheeses are allowed too- don’t have to be completely lactose FREE but low- 2-4 g max per serving.

Hi Laura. You are not alone. I have yet to find a fruit that I truly tolerate, despite being low FODMAP (such as grapes and pineapple). Vegetables are not great either but seem to be a little better than fruit. I haven’t given up trying yet and I am focusing on making sure that I am not eating any other hidden FODMAPS near the time that I am eating fruit to be sure that my reaction is truly to the fruit and not to something else.

If you are eating the fruit separately, try to eat it with something else that is not as harsh on your stomach and will lower the fructose level. Possibly some protein. I cannot do raw pineapple, I will get horrible bloating, but funny thing is, if it is cooked into something, I’m ok with it. Also, check and see if you are eating fruits out of a can, make sure they only adding water to it, and not any additional sugars or sugar alcohols, juice concentrates. Juice is a concentrated form is always going to be higher in sugar than the actual fruit itself. Thus, drain all juice off and even rinse with tap water before eating. Hope some of these tips may help

Further up the comments (January 29), you said that there are opiate like chemicals in dairy that slow the bowel down. Could you please provide the details of some references that I could read to learn more about this? (Journal articles are fine – I am able to access these.)

Also, in the Cracking Myths article you posted in another section of this site, in Myth 6, a dietitian is quoted as saying that when you can identify the immunological triggers, restriction of FODMAPs proves unnecessary. Are you able to explain more about this?

Hi Nikki: Glad you stopped by my blog. The opiate like chemicals are bioactive peptides derived from dairy foods. This is area of needed research (I think) and my comments in regard to this topic are more out of curiosity–could these peptides impact bowel function? Since you have access to journal articles, you may want to do further exploration. I love delving into the research and try to connect the dots for my clients. Wish I had a bit more time to do this!
Here is one article to check out: http://www.ncbi.nlm.nih.gov/pubmed/22139569
The cracking myths article-was a quote by a dietitian that does LEAP testing–if I recall correctly?! Here is a website that may help you: http://www.nowleap.com/index.html This is not my area of expertise so I would encourage you to reach out the author of that quote.

Hi Kate, I’m actually scheduled to see an RD who does the LEAP testing. Have you heard much about it or know anyone who has had some success?
Also, regarding the dairy comment, I can share from personal experience that any dairy puts a complete stop on my bowel movements. This seems to be the opposite for most so I always thought it was just me! Thanks for the article link.

Hi, and thanks for your incredibly helpful site!
I’ve diagnosed with IBS for about ten years now, and mostly kept it in check by avoiding high fibre content and beans/cabbages/peas and the like, interspersed with medication to stop/prevent diarrhea.
However, I’ve also been using fennel tea to avoid “cholic”, i.e. painful bloating and excess gas, with good effect. And now I see it on the high-FODMAP list… :/
I don’t drink all that much of it, but I’ve been known to force down (I don’t LIKE it) a cup when the symptoms become painful and limiting.
Is it a complete no-go, or just “limit yourself”?

And COCOA POWDER! Is this just in powdered form, or does this apply to all forms of chocolate?!?
I’m a serious chocoholic, and dark chocolates is one of my few remaining pleasures.

Annika-Fennel tea was quite high in FODMAPs. I would suggest you avoid and perhaps try it after you re-challenge your diet with FODMAPs to see which are problematic for you. Don’t worry I haven’t let go of the dream that dark chocolate might just be okay on the low FODMAP diet. The FODMAPs in cocoa powder from what I understand are fructans and GOS –and these are fibers–so choose chocolate with lowest amount of fiber. And hopefully we’ll get the word soon from Monash about chocolate.

Thank you so much for your quick reply!
I haven’t actually gone on the 100% full elimination diet (though we’ve tried it on Jr.), my summer is just making it impossible (going on LARPs, etc) – but I’ve been good and cut most of the FODMAPs from my diet and the effect was very noticeable – bloating and gas-problems went away nearly overnight!
I’ve still had a few “attacks” of my “normal” diarrhea, but that may be due to occasional “risky eating” as well as the proven PMS connection.
I don’t appear to be “hypersensitive” to anything in particular, but I do get the fat-triggered attacks and fiber is a no-go for me.
So I think I’ll stay on my low-key low-FODMAP diet for now (as it seems to have a very benificial effect on my everyday digestion), and strike out into “bad eating”-land when I feel ok to risk it.
Saturday as chocolate day is ok, because if I have a reaction, I’m usually ok by Monday again.

I’d allow up to two days to experience all symptoms, depending on how you respond to the different FODMAP groups. Thank goodness there’s a list because I don’t think I would have ever figured out those late-triggering ones on my own. Keeping a food and symptom journal is also a valuable tool.

Hi, I have been doing this diet with a dietician, and have just finished the challenge phase. I’ve ended up having problems with every group except for galactans. Has anyone else had this? Not sure what to do now as I don’t want to cut all of those foods out forever but I feel so much better since doing this diet! IS it likely that only certain foods from those groups can cause problems, or if one causes a problem will all of the others? For example I’ve tried bread on the challenge phase but no garlic. Any help would be great! Thanks!

Steph, It is possible that other food items with less of a FODMAP amount in that group may be tolerated. Did you try 1/2 a challenge amount of some foods-that is helpful too? Say, try 1/2 a clove of garlic instead of a whole clove. Or try sourdough white bread instead of multigrain or whole wheat. Tolerance to FODMAPs can change over time so re-challenge again in a month. Also, if you have small intestinal bacterial overgrowth (SIBO) –tolerance to fructose may be an ongoing issue. Many individuals treated for SIBO often resolve their issue with fructose malabsorption–so this is a condition I like my clients to be screened for.

I didn’t try 1/2 a challenge so will definitely do that. I can live without bread/pasta etc as I’ve found that easy to cut out and feel like I have a lot more energy now. But things like onions and garlic are obviously very hard to keep out of a diet especially when eating out. Thanks for your advice. Is it easy to test for SIBO? Do I just ask my doctor to do this test or do I need to ask my dietician? Thanks so much.

Small intestinal bacterial overgrowth is typically tested with a lactulose breath test. Your primary care doctor or GI specialist can order the test. It is generally administered in a big hospital setting. Onion is a tough source of FODMAPs to get back into the diet I have found for my clients but certainly traces such as found in ketchup seems to be okay for some. Garlic seems a bit easier–so would start there!

My dietician (part of Sue Shepherd’s group)suggested cooking something with chunks of onion and then pulling the onion out before eating as a way of testing onion tolerance. She also suggested starting with spring onions, then garlic and then moving onto onions themselves as any problems with spring onion and garlic will mean that onions will also be problemmatic

Kaz…thanks for sharing these great tips!! I think challenges should be done very gently with the goal to try to incorporate as much FODMAPs back into the diet as possible…even if in trace amounts! These tips will be appreciated by many.

Thanks for the tip! Will definitely give this a go. My dietician is great but FODMAPS is new to her and I think I am her first patient who has tried the elimination/challenge phases so she doesn’t always have tips. It’s great to read blogs like this for help!

Hi Kate, really fantatsic website thank you! A couple of questions for you. I gather that usual fruit juices are out but how about green veggie juices?

I’ve heard green juices are really good for cleansing and getting nutrients in but I wander if they would be too concentrated? Maybe too easy to get too many greens in one go? I’m thinking of juices that have say spinach, cucumber, celery, carrot, lettuce – only fodmap friendly veg.

Also I’ve tried subscribing to your blog a few times now but i’m not getting a confirmation email through – is it working? (I have checked my junk folder & it’s not there either). Thanks in advance!

Butter is low FODMAP. You can have it on the elimination phase. Fat can contribute to IBS symptoms when overdone–so don’t go overboard. Molasses…I have not seen any data on molasses from Monash. US info has molasses as having more fructose than glucose…but in 1 TB the amount of excess fructose is below the Australian cut-off for excess fructose….So I would say small amounts are probably okay–if it was used in large quantity –it might be an issue. Since molasses in the GF rice chex is the last ‘food’ ingredient in the product before all the many vitamins that are added….I think it would be okay.

Thank you, Kate. I purchased your eBook and really appreciate your blog. So much good info. I have also tried some of your recipes and am enjoying your granola. Over the past 2 weeks I completed the lactose and fructans challenge. Had some problems with lactose especially and just found out that the hydrogen breath test was positive for lactose intolerance, so will be researching more in this area. I am also suspecting fructose may be a problem and that will be my next challenge. Very appreciative of your’s and Patsy Catsos’ sites!

Kate, do you know of any comparison charts showing the similarities and differences of the Specific Carbohydrate Diet and the low-FODMAP diet? I love your checklist but may need to exclude more foods to overcome and prevent SIBO. Thanks in advance!

I don’t Joanna, but one of my blog followers may chime in. There is no evidenced research based diet for SIBO. I am not sure that SCD is necessary…I think it may be overly restrictive for some. (Just my opinion) I like the book, The New IBS Solution by Mark Pimentel as a resource to understand SIBO better, the book is a bit outdated but I think it provides some valuable info. I have had many clients successfully use the low FODMAP diet post antibiotics….for SIBO treatment, but like SCD there is no research using it for SIBO.

Kate, which diet do people follow while taking antibiotics? I will take the breath test in a week, and I’ve been following a combo of the FODMAP/SCD for about 3 weeks. I wonder how I should eat while taking antibiotics. Some people advice expanding the diet to make the “bacteria come out of hiding”…although nothing feels like it’s been hiding so far (symptom wise).

TJ, I encourage my patients to liberalize their diet just a little to help get the bacteria up and running–maybe 1/2 an apple and some garlic at dinner–not over the top FODMAPs to make them feel miserable. We don’t have good research to adequately support diet intervention for SIBO–so much is based on clinical observation from those that work w/ patients. I hope that we have a more detailed and research based approach to offer patients being treated for SIBO in the near future–but the science isn’t there quite yet!

Dear Kate,
I have tested positive (not strongly, but strong enough) on the Hydrogen Breath test for Lactose. I am also able to nominate to get the Fructose one, but it being at my own cost and having to miss 1.5 hours work at its expense, I am not sure if it is worth it? I definitely feel too much fruit, and sugars and fructan (esp Wheat) types do trigger symptoms. But is it very likely for me to be positive? Is it right that people anyway do not have the biggest tolerance of fructose? So I am wondering is there much the test can achieve, as I sort of feel although a reasonable price, that it may just be me being over zealous and a waste of money. Is it very rare to test positive?

I have felt ridiculously sick this weekend post-test, as I decided to have a lactose blow out before cutting just lactose out for 4 weeks, it was very silly, especially as against my own better judgement I have been eating wheat. I find it so hard to remember to keep motivated!!

*only 35 euros, definitely can afford it, and work would let me make the hours up, it is just the bother of it if it is likely to be in vain, and wanting to know from a trusted yet knowledgeable source, as the Doctors obvs have a motive for the test!

Hi Ellie, Certainly deciding to do the test or not is a good question to ask yourself and your doctor–BUT for many of my clients we test their tolerance to fructose with the challenge phase of the diet. In some clients that are so sensitive to FODMAPs-I don’t want to send them for testing which involves a huge fructose load and set them up for a miserable few days post the test. (just my humble opinion). …especially when we are highly suspicious that they have fructose malabsorption.

I will try lactose elimination, then when that doesn’t solely work again, I will add elimination of fructose, and if I see a big difference, test it I think. Can wheat and fructans be included as a reaction to fructose?

Which of my symptoms can be put down to Fructose? I know I definitely reacted badly to asparagus and I react to wheat and sugary things and I don’t know, lots, but then I get confused! As FODMAPs anyway include Fructose in that list, I am confused how to differentiate symptoms. Gas, pain and D, could all just anyway be IBS type things. That is where I am confused as to knowing if someone is definitely reacting to fructose?

Ellie, you remove all FODMAPs on the FODMAP elimination diet for 2-4 weeks or so as instructed by your dietitian.. then add back each FODMAP group individually (1 FODMAP group per week) with certain test foods that only have that FODMAP. Remain on the low FODMAP and only add back the test food. If testing for fructose, you would add about 2 tsp. honey to your low FODMAP diet for 3 days. If you symptoms remain calm, then you can try adding another excess fructose item such as 1/2 a mango. Although fructose is the most rapidly fermentable of all FODMAPs-all FODMAPs contribute to similar symptoms so you can not differentiate which FODMAPs will or will not trouble you based on symptoms. They all have cumulative impact on symptoms.

Vita fusion multi-vitamin gummies should be okay. Many of my clients tolerate them. Cellulose is not a FODMAP. Peas are okay in small limit. I have no data on pea protein…may be okay, might not be…hard to say. Almonds are okay in a 10 almond limit. Its the water-soluble fibers GOS and fructans that are problematic in almonds but if you keep to the limit –they should be in a tolerable amount. When you make almond milk typically you start with a large quantity of almonds–certainly more than 10–and the water-soluble fibers can leach into the milk making it a potential high FODMAP source. Hope that helps. Lots of little nuances with this diet, right? Glad you stopped by my blog.

great site, such a great place to get information on such a complex diet. I have a question about a supplement that ive recently come across and would like to take it as a natural way to help my hormonal acne and iregular menstruation. Its called DIM, there are several brands but im not sure that its suitable for a fodmap dieter as the main ingredient is based on deiindolymethane, a phytonutrient found in cruciferous vegetables.

What is it about cruciferous veg that makes them fructans, would the dim be ok as it just has that one nutrient in it or is it that that one nutrient is what we find hard to digest? Any thoughts would be appreciated!

I think the DIM would be okay. Not all cruciferous veggies have fructans and GOS–common cabbage for instance is low FODMAP. Fructans and GOS are fibers that are not digested in the human body. Hope that helps.

Is the Whey used by athletes as a protein source FODMAPS friendly?
The one I use contains crystalline fructose, whey protein isolates and whey peptides.
Also, if soft cheeses are bad, why are camembert and brie acceptable? They are very soft.
Is feta cheese alright, and is it just hardened whey?

Not all whey products will be FODMAP friendly. Certainly any product with crystalline fructose would be out (not low FODMAP) as it is a source of excess fructose. Whey protein isolates are low FODMAP while whey protein concentrate MAY contain lactose. Overall most cheese is low FODMAP (low lactose) unless it is super wet…(cottage, ricotta cheese would not be okay). When cheese is made the protein curdles and the whey is drained off along with the majority of lactose. Many individuals even with lactose intolerance can tolerate a few grams of lactose per sitting…feta has about 1 gram….so it is allowed.

Cody, If I had to guess (and it would be a total guess) I would imagine the liquid supplements would have more sugar alcohols than tablet. But, I wonder if you could contact the pharmacy or manufacturer for exact info?

Hello, just starting to do my shopping to start fodmap diet on Monday and got a bit confused about the lactose free milk. Is Almond milk ok ?Someone told that it is not ok and better use rice milk? What is your opinion? Thanks Brigitte

Hi Brigitte, When doing the elimination phase (as you are doing), I recommend avoiding almond milk and using coconut milk, lactose free cow’s milk or rice milk. Testing your tolerance to almond milk when you undergoing your FODMAP challenges can be done after you have completed the low FODMAP elimination phase. Almond milk has NOT been completely analyzed for FODMAPs but preliminary results show that it has GOS FODMAPs. Some brands may has less GOS (FODMAPs) but we just don’t know that yet.

It does say it’s just for iPhones on the website but if you download the app onto your iPad it works fine on your iPad as well. It just comes out a little blurry as it’s been stretched onto a bigger screen, but works great & really useful you should get it.

I discovered your blog recently and have found it extremely supportive and helpful. It is a wonderful help to those of us with IBS or related problems. I had a lactulase breath test done at Genova Diagnostics. They said the results were negative since the hydrogen and methane increased by 11 ppm in the first 60 minutes. However, by 90 minutes the increase was 24 ppm and by 120 minutes it was 53 ppm. The report says that was due to fermentation in the colon. How would you interpret those results? I suffer almost constantly from gas and bloating.

Would really need to see the results–but it sounds to me that you could be positive. Can you have it read by another GI –bring the results so they can see hydrogen and methane numbers at each measurement.

Hi Craig ! Everyone malabsorbs lactulose in the colon so the test only looks for significant malabsorption in the small intestine (the sugar will usually reach and exit the small intestine in the first 60 mins after consumption). If your hydrogen/methane was to increase significantly during the first 60 mins, it would suggest that bacteria is not where it’s meant to be – Small Intestinal Bacterial Overgrowth (SIBO). But your increased results after the 90 minute mark suggest normal malabsorption is occurring in the colon (there is meant to be bacteria in the colon. These bacteria ferment the lactulose as humans are no designed to absorb it). Hope this helps !

Kate’s response to Kahil and Craig: Bear in mind, in slow transit (ie constipation) the time it takes lactulose to travel to the colon may be longer==so it is difficult to interpret increase results definitely at the 90 minute or later timeline in this population.

Do you know if there’s any data aligning particular FODMAPs with constipation as opposed to diarrhea? For those of us with IBS-C, it’s an added challenge to try to link particular foods to particular symptoms – i.e., I never know if it was something I at last night, yesterday, or a week ago that is bothering me!

It’s hard to tell how long it takes for the FODMAP to initiate symptoms in a constipation predominant patient. I am not sure if certain foods contribute more to constipation–I think it’s all about the type of bacteria in your gut and which gas they are more likely to produce and how generous you are feeding them with poorly absorbed foods–methane producing microbes are linked with constipation and weight gain. My goal with constipation predominant patients is to titrate their fiber and fluid to their individual tolerance and help keep them regular and lower FODMAPs in an effort to maybe starve those pesky methane producing microbes to at least get them in a better balance.

I am very confused. I now have a gastroentoligist, and they are testing me, as it was a doc in another country who said IBS with only a blood test and my own reports. New doctor: I have had a negative stool test, and a ultrasound checking my innards and also all good there, lactose test I was told I am a bit lactose intolerant, and so I have put alllll my hopes into this fructose test today. After testing just cutting out lactose and including fructose in diet, I found once I cut it out for a couple weeks now, stuff was better, even more better if also cutting out wheat etc, and fructan things. I was so sure I was going to be intolerant, but I am not. Apparently totally normal. My stomach didn’t feel good, and there was gas and belching, though I guess that is having loads of sugar after fasting?

Anyway, I am very confused. Does this mean, as I am still IBS, I can do fodmaps but I can eat fructose? Is the key perhaps, I am likely to overindulge in Fructose and Wheat when I *do* eat them, and that is the problem? They also talked of another breath test, sweeteners or sugars or something? I am so confused and I hope you know of other people who test negative for Fructose but are IBS and sensitive! Wit’s end.

Ellie,
The breath tests are not always accurate so perhaps it was a false negative OR…interestingly, research has shown that even with adequate absorption of some FODMAPs they still elicit symptoms –so even if you digest it, the presence of the some FODMAPs in your intestine still draw water into your bowel and cause distress. I would do a 2 week FODMAP elimination diet and then go through the re-challenge phase and assess your symptoms as you re-introduce various FODMAPs in your diet rather than relying on the breath tests.

That sounds sensible. I can’t help thinking this has to do with my greediness though, I am overweight and will eat too much or too fast, even if mostly eating the right things, I will overeat out of greed. Like pre-fodmaps had me eating several servings of fruit in one sitting. And after initial fodmaps, I had fodmap friendlys in larger amounts. I am now curious whether I need to mainly eat as varied as I can (another issues I find on fodmaps, I am just lazy though, and often fussy), in small portions, of things quite healthy? And maybe severely limit grains like wheat and spelt, no lactose, and severely limit fruit? Because at first in my fodmaps I also ate a lot less and a lot more healthy variety of veg. Can it be portion control may save me? I have just had a nap because of awful headache and acid reflux and tummy things probably brought on by the fructose test! Surely I would be feeling fine if truly ok with it?

Not a FODMAP question, but a technical question: is there any way to add an option to this blog to deliver a daily digest of postings instead of getting an email for each message? I like seeing the messages and find this blog very useful, but I’m already inundated with emails, and it would be much more pleasant to get one email per day in which I could read all postings. I know other WordPress blogs support this; can yours?

Hi Kate,
I’m from the Netherlands and I just started the FODMAP diet this week. I recently met with a dietitian, but in Holland this is quite a new diet, so she didn’t have any experience with it. So I have to do most of the research myself, which can be quite difficult because there are many blogs and sources on FODMAP who all list different things on high and low fodmap food. I just read your latest check list and it did say that black tea and espresso is ok,but my dietitian told me that during the elimination phase I’m not allowed to drink black tea and any drink that contains cafeine. And I also saw on your checklist that a small amount of broccoli and avocado is ok, I was wondering if this is also ok during the first 6 weeks of the fodmap diet, or that it is better to eliminate this foods? Because on many websites they list avocado and broccoli as high in fodmap.
Sometimes I’m a bit lost in translation with all the fodmap stuff since all websites are in English and often list products that are not very common in the Netherlands.
Thanks in advance for answering my question.

Hi Sanne, Following the low FODMAP diet can be a bit frustrating because the diet is SO new and is STILL evolving as we speak. Some dietitians like to eliminate any potential IBS triggers in addition to FODMAPs–caffeine being a potential issue for those with diarrhea predominant IBS. I tend to allow as many foods as possible. In my practice, I encourage a one to two cup coffee or acceptable tea limit unless my clients finds it to be trigger–in this case, I would pull it off the table while we undergo the elimination phase. FODMAPs seem to be the biggest IBS triggers but for some –intolerance to fat or fiber can play a role in their symptoms too. Generally, I start with the low FODMAP diet first and add in any other restrictions if the patient has continuing problems or explore other health issues with their GI doctor such as pancreatic insufficiency, small intestinal bacterial overgrowth, hormone disruptions, pelvic floor issues, gastric motility issues, etc….( I digress….) Avocado and broccoli have some FODMAPs but in small amounts are below the threshold for FODMAPs in certain portion sizes. So…I allow 1/2 cup broccoli per sitting or 1/8 avocado per sitting–I would not encourage to eat both at the same time. Just one ‘moderate’ food allowed per sitting. Other moderate items include celery and beets for instance. It is easy to get lost in translation with this diet–as it’s all about portion and cut off amounts–and it can be tricky without a dietitian to help guide you. Glad you stopped by and I hope my answer was helpful.

Hi Kate,
Thanks a lot for your answer, it is really helpful. I just finished my first week of the FODMAP elimination phase, but it is still quite frustrating. My main IBS complaints are severe bloating (I often feel 9 months pregnant), resulting in abdominal pain, especially on the left side of my belly, flatulence and at times constipation. I am almost under the impression that my complaints have decreased this past week, I already woke up in the morning with a tensed belly and during the day the severity of the bloating only increased, being worsed after dinner. And I also have experiences some dizziness and lightheaded although I eat quite regularly. So I almost feel like I’m doing something wrong. But hopefully in the second or third week my complaints will slightly diminish.

Back to the cafeine, as I understand it correctly, it is ok to drink a cup of coffee a day, as long as you don’t suffer from diarrhea? And I have another question, hope you don’t mind. But dates are listed as high in FODMAP as well. But many gluten-free bars contain dates (and nuts such as almonds), is it ok to sometimes eat a bar made from dates or beetroot or is it best to eliminate these foods during the elimination phase?

It’s hard for me to advise you specifically nor would it be wise to provide individual guidance over the internet but I do allow coffee up to 1-2 cups on the elimination phase as tolerated by my clients–many with IBS-D find caffeine to be a trigger from my experience.
I would NOT suggest the use of bars made with dates.
Your bloating seems quite severe–I would be evaluated for small intestinal bacterial overgrowth and work with a gastroenterologist to help sort out any other underlying disorders.

Hi Kate, Sorry if you answered this question elsewhere on your blog but I’m wondering about a few things: do you know if these are low FODMAPS: hemp seeds, coconut aminos (soy sauce substitute made with coconut sap) and kelp noodles?
What about pumpkin (I live in the US)?
Thanks for your great blog!

Saski–Hemp seeds have not been tested. I tried mailing some to Australia for testing from the US and either customs or the airlines would not allow them to be shipped so they came back to me! I think coconut aminos might be fine–can’t say for certain. NO idea on kelp noodles. And…finally, pumpkin!! I shipped US pumpkin to Australia and it is being tested as we speak or very soon. I have been told I may have some info by Thanksgiving.

Kate, I noticed tomatoes are listed as OK to eat on a low FODMAPS diet. However in my Sue Shepard book there is a brief reference to only eating 3 tablespoons of tomato paste per meal…should I be limiting my quanities of just plain ‘ol regular tomatoes?

Saskia- the Monash researchers allow 1/2 cup canned tomatoes on their app–so I think that would be a good limit. Tomato paste is a concentrated form of tomatoes (likely excess fructose in this form)–though not listed in their app–sundried tomatoes are included in the Monash app and the limit is 2 Tablespoons.

Joanna, Good question–but doubt cooking would make foods lower in FODMAPs. Soaking some food allows leaching of water-soluble fibers (GOS and fructans) to lessen in legumes–this is why canned legumes have less GOS than those simply soaked quickly and cooked. The longer the legumes soak the more of the GOS leaches into the fluid and can be drained off for lower (but still moderate-high) FODMAP content.

I checked the label of Progresso 100% Unsalted Chicken Broth and the ingredients are Chicken Broth. It says it contains less than 1% of: Sugar, Yeast Extract, Natural Flavor, Carrot Puree. On the front it has a picture of green pepper, tomato, onion and carrot. It is gluten free. I know onion leaches in liquids and needs to be avoided. I read in Sue Shepherd’s book that natural flavors are fine. I am confused about this product. In the Nutrition Facts it lists sugars as 2g, total Carbohydrate as 2 g. Would this be ok to use? Thanks much for your input!

Natural flavors in the US can refer to onion in the US. Perhaps Sue’s book was referring to laws and regulations in Australia. The amount of fructans that could trigger could be as low as 0.2 grams fiber. Food manufacturers can round to the nearest 1/2 gram so an item that has more than the fructan cut off limit may actually appear to have no fiber even though it does.

I’m writing my master thesis in clinical nutrition about FODMAP and have been looking around for the cut-off values. I’ve found some from 2010, but they are not the same as yours. Do you have an article that I can look it up in?

I believe Sue Shepherd reviews cut off values in her books. I received the info for cut off values from the Monash team at a conference I attended at Monash. I am not sure they have actually published these values. The values are based on clinical observation rather than a specific research study.

Could someone share some brands of extra-firm tofu that are definitely FODMAP-friendly? I have tried Nasoya and Wildwood, but I seem able to tolerate (in small amounts) only the Morinaga silken kind. To make it lower in FODMAPs, I remove it from the carton, wrap it up and freeze it for a couple days. I noticed regular tofu bothered me long before I had any kind of chronic IBS issues. I wonder if something else be the problem. I drink 8th Continent (plain) soy milk all the time with no trouble.

Could someone share some brands of extra-firm tofu that are definitely FODMAP-friendly? I have tried Nasoya and Wildwood, but I seem able to tolerate (in small amounts) only the Morinaga silken kind. To make it lower in FODMAPs, I remove it from the carton, wrap it up and freeze it for a couple days. I noticed regular tofu bothered me long before I had any kind of chronic IBS issues. I wonder if something else could be the problem. I drink 8th Continent (plain) soy milk all the time with no trouble.

I have been following the FODMAP diet for a few weeks and it is helping a lot with the bloating, I am about 70% less bloated. However, I am at a point where I’d like to be 100% bloat free…I suspect I am mostly sensitive to fructose. So I was wondering, do you think that substituting sugar with glucose (dextrose) when cooking would help even more? Thanks!

Martine-perhaps it might…though we think the even distribution of fructose-glucose should help with absorption. In clients that benefit from low FODMAP but not fully–I wonder about small intestinal bacterial overgrowth–have you been tested for this?

I haven’t been tested, but 2 years ago I went to the US to get a doctor to prescribe me Xifaxan and he agreed. I took it for 2 weeks, 3 times daily, with no modification to my diet, and I saw no results. This summer, I also tried the Vivonex diet for 20 days, yep, 20 days drinking that, and it did not cure the bloating. As soon as I started eating normaly it came back full force. I have a very nice Gastroenterologist but he would not comment on SIBO, I think he didn’t really believe in it. Maybe he was right since Xifaxan and Vivonex did not help. But do you think I still should get tested on SIBO? I could probably find a way…

Aimee–Have you had motility testing? Do you space your meals out–allowing 3-4 hours between eating –which may help with the intestinal cleansing waves that only initiate a cleansing wave in the fasting state (ie when you are not eating)–this may help move some of the trapped gas.

I did not have motility testing but I did try domperidone (motilium), and it helped with the bloating of the stomach, but not intestin. I also tried Resotran which did nothing. It’s true that spacing out meals does help me, but I admit I don’t do it all the time… A weird fact is that when I breastfeed ( I had two children) I am not bloated at all…. Anyways, the FODMAP diet does help a lot, I just sometimes wish I was 100% normal.

If I will elimante the chocolate, will it be a fodmap friendly bar? and will it be best to use peanut butter instead of almond butter? Although I would think that almond butter would consist of less fat compared to peanut butter? And is sunflower seed butter fodmap friendly?
It is so hard to find glutenfree bars that do not contain dried fruits to keep the ingredients stick together. So I was really glad when I found this recipe, but wanted to check for sure if it is fodmap friendly. Thanks!

I like that recipe for granola bars…definitely worth a try. I think the peanut butter would be your best bet for lowest FODMAPs. The classic unflavored sunwarrior protein powder is simply brown rice protein powder…so if you must add some protein powder this would be your best bet…the vanilla flavors are not suitable.

Hi Kate, thanks for your reply, your blog has been really helpful for me. Unfortunatelty, after almost 3 weeks my complaints haven’t reduced at all,but hopefully in the upcoming weeks the bloating and flatulence will slightly decrease. I will also contact my gastroentologist about the small intestine bacterial overgrowth.

And I had another question, I just saw these coconut bars in the store and I was wondering if you think if they are suitable for the elimination phase. The ingredients are: Cocoa butter *, raw cane sugar *, * 17% Rice Milk, Cocoa Mass *, Coconut * 5% * Vanilla, Cocoa Ingredients least 48%, * = Organic

Wow, no, nobody ever mentionned an endocrinologist…but it could make sense. Also, I am tired ALL THE TIME, even if I sleep 8 to 9 hours per night. I will ask my family doctor for a referal to an endocrinologist. I am not sure how to explain or justify the need though…but will definetely try. Thank you!

I have had a few tough cases solved by a good endocrinologist. Discuss how your bloating is not an issue when you are breastfeeding. Fatigue can be due to hormones or often low Vitamin D levels–low iron. Keep looking for your answer.

Yipes! One of my prescriptions just changed. It went from a tablet (containing lactose monohydrate) to a chewable containing sorbitol. The full list of inactive ingredients is: sesame oil, linoleoyl polyoxylglycerides, DL-alpha-tocopherol, dehydrated alcohol, gelatin, sorbitol, and glycerin. This doesn’t seem like a lot of sorbitol, but it’s bound to be pretty sweet since it’s a chewable. Kate, can you please advise whether this could be acceptable or if I need to ask my doctor for another drug?

And as you can see they contain broccoli, and polysaccharides, and maybe other things too than I’m not aware of is high in FODMAPs.
Is it enough broccoli and polysaccharides in it to be bad for me who’s on a FODMAP diet?

Jenny, Unfortunately I don’t have time to review all of your supplement questions. But, I can tell you polysaccharides are not FODMAPs–they are longer chain carbohydrates. As for sorbitol and mannitol in supplements –the amount in them is probably inconsequential but I do prefer to choose supplements without these ingredients when possible. And there are other Vitamin D choices that do not have FODMAP ingredients.

Hi Kate,
Is it possible to be intolerant to fresh dairy even if it is lactose free? I can eat aged cheeses like cheddars feta etc. But I think maybe when i have had lactose free cows milk may have upset my tummy?

Samantha-That is an interesting observation and I am not sure. I do have some clients that can only tolerate so much dairy- perhaps it a dosing effect–some people have difficulty with different types of casein (proteins) in different milks.

Yes the casein in fresh dairy products i think may of been upsetting my tummy. I have had to give up the yoghurt I was making to as I feel my system has become intolerant of even low amounts of lactose but I still was noticing same symptoms even with the lactose free milk. Its more of having a protein included in my breakfast rather than eggs or fish. i am going to try soy milk now, ‘so good’ is made with soy protein not the beans so is ok right?
The protein amount in so good per 100ml is the same as milk so its a good substitute.

‘So Good’ Original ingredients online list Soy Protein (Whole Soybeans and Soy Protein Isolate), so unless it says differently on your carton, this WOULD contain the whole bean (FODMAP), although less than some brands that use only whole soybeans. I have not seen that brand in the U.S. I use ‘8th Continent’ Original soy milk.

Hi Kate. I’m thinking of giving sourdough bread a try (as you have said many times that some people will tolerate this bread specifically), and I just wondered if there was a specific brand that you recommended. Thanks.

Hello, My GP put me on the FODMAP diet about a week and a half ago without referring me to a dietician, so I’m going it alone for now. I’m finding the Monash FODMAP app incredibly helpful and really I couldn’t do this without it. Definite improvement in the gas and bloating situation, but I’m finding that at the end of the day I occasionally get these symptoms, as well as cramping. I’m sticking with low FODMAP foods, but I know there is a cumulative effect and it could be about the combination of foods. are you aware of anywhere that lists the levels of FODMAPs in low FODMAP foods so that I can check that I’m not combining in a way that loads up on one or more FODMAPs?

Rebecca–There is limited updated published info on the FODMAP content of foods. Monash has published 3 papers but much of the food analysis and data is for 100 grams of the food –which may or may not represent a normal serving size –depending on the particular food.

It could be that you will note less of these symptoms over time while you continue to modify your gut bacteria with the diet. You may want to continue for another 2 weeks and see if you note better symptom control–If not, you might consider small intestinal bacterial overgrowth testing –or perhaps try adding a probiotic.

I wanted to eat sushi tonight, but now I just found out that surimi contains gluten. Do you know if surimi is a definite no-go during the elimination phase?

And I had a question about tomata passata, do you know if it is low in fodmap if it is 100% sieved tomatoes? And I just had another question about chocolate, I know it is not tested yet, and I read in one of your blogs that you should take chocolate with a low fiber content. but I was wondering how you could identify the fiber content of chocolate? Does this mean pure chocolate with a high or with a low cacao percentage?

And one last question, can you maybe say something about if the ingredients of this coconut bar are low in fodmap? And I had another question, I just saw these coconut bars in the store and I was wondering if you think if they are suitable for the elimination phase. The ingredients are: Cocoa butter *, raw cane sugar *, * 17% Rice Milk, Cocoa Mass *, Coconut * 5% * Vanilla, Cocoa Ingredients least 48%, * = Organic

sorry for all the questions but you are my most reliable source on this FODMAP diet. Many thanks for all your help and delicious recipes!

Hello –
Any word on pumpkin if it is allowed? I’ve been eating so much lately since I saw it was allowed on the list I was following. Oh no.
Stevia I assume is okay.
Pineapple and maple syrup threw me off as that’s so sweet and thought it would be full of fructose.
Vanilla extract?

Thanks so much for this site! I plan to find a dietitian to work with as soon as my vacation is over (I don’t want to be a pain to my family). In the mean time I’m trying to cut down on FODMAPS myself.

I have 3 queries:

1) Regarding fennel. One of my favorite teas, “Eaters Digest” has “Bitter Fennel Fruit”. I contacted the company to ask what exactly that is and this was their response, “The part of fennel that we use is the “fruit” which most non-botanists would call the “seed”. The fennel plant has several different botanical varieties, bitter fennel is used to support digestion and other related health issues, sweet fennel is used for cooking as a seasoning, and Florence fennel (a.k.a. bulbing fennel) is used in cooking as a vegetable.”

2) Are enzymes containing Lactase alright?

3) Probiotics have so many ingredients that sound like lactose…are there any to watch out for?

So, after following an extremely restrictive diet for about 4 years due to some misleading blood tests (thought I was allergic to gluten, dairy, eggs, soy, peanuts, etc despite negative skin tests and negative celiac blood tests and biopsy)in addition to trying to eat GP friendly (I do have gastroparesis)and low FODMAP and still being symptomatic (!), I’m trying to focus on just the FODMAP and GP aspects for a while to see if I can finally get to a place where I feel well again.

Since I have not eaten dairy for years, almond milk has been my main milk (I get Silk pure almond vanilla unsweetened). Would you suggest that I stop that for a strict FODMAP trial? I know you have mentioned almond milk a few times before, just wondering if there is any specific data yet, especially regarding specific brands. I drink some rice milk too but not too much because it makes my blood sugar spike.

Would you recommend that I do FODMAPS strictly for a while without trying any gluten or dairy, or should I go for things like plain lactose free kefir or 100% spelt bread right away as part of my trial?
The thought of enjoying a slice of bread or cup of lactose free yogurt is so appealing, but I wonder if that would be too much too soon.

Katie–I would advise with your history that you work closely with an RD–I can’t give out specific diet recommendations in a blog format. Sunflower seed cut off is just 2 teaspoons and cocoa is 3 teapsoons –so products made them are okay if they are a small portion. Almond milk likely is high in GOS–and I would avoid. Although I wish several brands of different alternative milks were tested for FODMAPs –we are not there yet. It takes 3 weeks to test a single food and its costly–so many foods have been tested but many more to go.

Saskia–have not seen actually data on acorn squash. Vinegar should be okay–some have excess fructose when consumed > 1 Tablespoon such as balsamic and apple–so would not overdo it. Not sure on all the pepper varieties–but bell peppers and chili peppers are okay.

Is there a good resource for a protocol to follow for FODMAP challenges? Patsy Catsos’ book? And, are there any considerations for reintroducing FODMAPs after resolving a small intestine bacterial overgrowth? I noticed you mentioned fructose could be an ongoing problem; wondering if fructose (or any other foods, for that matter) could actually cause SIBO to return?

Joanna–that is a great question! I like a gentle challenge approach–where small amounts of FODMAPs are reintroduced into the diet while you stay on the low FODMAP diet in a systematic manner. There are probably many reasons people acquire small intestinal bacterial overgrowth so its difficult to know exactly how the diet impacts the risk for each personal individually. I would encourage meal spacing 2-3 hours or even 4 hours apart if possible to allow for cleansing waves of the small intestine. And test your tolerance to FODMAPs with a gentle challenge–meaning don’t try to push too much of the challenge food on yourself but rather slowly increase the amount of challenge food over 3 days to see if the food triggers IBS symptoms. If it does trigger symptoms–avoid that FODMAP group for a few months and then re-try that challenge –as tolerance to FODMAPs may change over time. And then start your next FODMAP group to challenge. Fructose malabsorption can be corrected with small intestinal bacterial overgrowth treatment –so may or may not be an issue.
I believe Patsy’s book does review challenges–but just approach them with the gentle approach rather than really indulging in a FODMAP group. So for lactose –I would start with 1/2 cup of milk on day #1 then day #2 try 1 cup of milk if passed day #1 challenge–and then day #3 stay at one cup of milk. Hope that helps.

My question relates to the latest comment of Joanna. I read your advise on how to introduce lactose. What would be you advise on reintroducing fructose and fructans? I’m almost at the end of my elimination phase of the diet. And I would very much like to try apple, avocado, dates, almond milk and almond flour. Do you have any tips on how to deal with the fructose and fructans group?

And I recently talked to my gastroenterologist also about small intestinal bacterial overgrowth. You once pointed this out to me as a possibility since I have very severe bloating complaints. But she was quite convinced that I could not have SIBO or any dysbiosis with bacteria. She said you can only get that after surgery.I’m still not very convinced cause I’m still wondering why I experience the bloating on a regular basis. Maybe will discuss this again with her on my next appointment. She also didn’t believe in the hydrogen breath test for fructose and lactose. I’m wondering if I still need to push the SIBO and fructose and lactose test to get any clear answer?
In a few weeks I will have a gastroscopy. Don’t expect any clear results of that, but will give it a try.

Hi, I would just like to chip in if that’s ok and just comment that I am also concerned I may have SIBO, but I was told it was not possible because I suffer from bad C and not D. I thought it was the type of bacteria though, with methane producing ones causing C

Jeramiah–not sure the steviol glycosides would be an issue–but some the of the Vitamin waters have fructose as an ingredient making it a poor choice on a low FODMAP diet. How about coconut water? There are also some gatorade products made with sugar that could be suitable.

You refered me to an endocrinologist a few posts above, for bloating issues…I got my family doctor to write me a referal (which was a bit tough!), and while researching for such a specialist, I actualy discovered I had one in my family, a cousin! So he is willing to help me and give me an appointment, but he appeared, eh, let’s say, surprised, that I would contact him for a digestive issue. So could you give me some pointers for this appointment? A brief history of cases you know of that were solved by endocrinologist? I understand this may not be the right place to do so, so please feel free to email me. Thank you so much!

Hey there Aimee–First for the blog readers–I just don’t want any confusion….I don’t really ‘refer’ my readers out to other providers–that is beyond the scope of the blog…but I do throw out some suggestions. Endocrinologists deal with treating hormone related issues–some that overlap with GI symptoms include low thyroid and ovarian.

Hello! I just came across this chart and your website and am intrigued. I have been feeling symptoms for a long while now but always pushed them off as effects of an old hernia (bloating mostly). As I’ve grew older, my symptoms have worsened and now – my early 30’s I am noticing cramps, pain, extra bloating etc.
I’ve tried everything and searched but could not find a real cause and as far as I know I have no allergies to foods. Long story short – I’ve done research and found many charts – all conflicting – and yours especially. How do I really know what chart to follow, what foods to avoid or limit etc? I’m so curious! I love food and to cook and refuse to let go of everything (it seems like) but it’s looking that way ! What do you suggest and how did you come up with this up-to-date chart?
Thanks!!!!!

Christina, I encourage you to work with a dietitian to help decide for one if the diet is appropriate for you and second to help you navigate it –the low FODMAP diet has many nuances.

The low FODMAP diet is relatively new and evolving. As such, there have been many iterations of the guidelines. I try my best to follow Monash University food analysis and stay on top of their latest research–Monash U does the bulk of the food testing and was the research center where FODMAPs was coined and the diet developed.

I have been implementing this diet since 2009 with clients and despite small changes in the foods allowed—the results are positive for the majority of my clients. FODMAPs have a cumulative impact on GI symptoms so once the bulk of the FODMAPs are removed –most IBS patients feel better. It’s unlike the gluten free diet where every crumb of wheat bread is detrimental. Also, the diet is NOT designed for long term–so no need to grieve the loss of your favorite FODMAP containing foods quite yet…the diet is typically followed for 2-6 weeks followed by a re-introduction or challenge phase to see what foods you can add back without GI distress.

Sorry getting back to this so late. Thanks so much and will definitely look into getting a dietician or at least trying to follow this on my own for a few weeks to see how it goes. The holiday’s are upon us and it is super hard to follow but I have been slowly removing onion, garlic and broccoli from my diet and have noticed a difference however some foods still seem to be giving me an issue (maybe black pepper or butternut squash?)
Anyways – thanks again – this site is great!!!!

Jackie, you want to avoid foods/beverages that have more fructose than glucose–so adding just fructose may boost the fructose higher than the glucose in that food or beverage–so best bet, yes, avoid items with added fructose. Does that make sense?

Hi Kate
I am just starting FODMAP diet and have a few questions.
1) coconut milk? seen some some definitely not OK, but Monash says coconut ok. I seem to OK with small amounts of coconut flesh/butter, but have a hard time with coconut milk. Not sure why this would be. Can you advise?
2)homemade nut milks. Been enjoying these (I am paleo diet as well) but sometimes seems like too much. FODMAPS say almond milk OK, but do not eat more than 10 nuts. Seems contradictory, I dilute my nuts 2X water to 1X nut volume wise, so even a half cup of nut milk has way more than 10 nuts. I soak my nuts before making the milk. Again, any advise welcome.
3)conflicting cabbage info. Some say common cabbage OK. Monash says chinese (napa?) cabbage ok, and up to 1 cup savoy ok, but does not mention green (common) cabbage. My main concern is that I eat kraut regularly. Does that change the situation? and can you clarify what cabbages are OK or not?
4) dried medicinal mushrooms and mycelia (eg. Reishi) in quantities up to 1-2 g. Should I totally avoid or is this small quantity OK?
5)colostrum OK?

Thanks
How do I find an RD to work with if I choose to? Is it important to work with someone in person?

Chris,
Coconut milk is low FODMAP–but sometimes it can have additives such as gums that are not FODMAPs but are still contain rapidly fermentable carbs so can be troublesome for some people. OR…some coconut milks have added inulin–which is a source of fructans/ FODMAPs. It looks like Almond milk will be high in GOS–the FODMAPs in almonds are water-soluble fibers SO…when soaked almonds are drained–the water soluble FODMAPs are retained in the liquid–the part that becomes the milk.
Cabbage–common cabbage–with the smooth skin–is allowed in 1 cup portion. Savoy in 1/2 cup portion–that is all listed on the Monash app. Not sure about medicinal mushrooms or colostrum.
Yes, I think it is best to work with an RD that is knowledgable in FODMAPs AND ideally in person.

Hi Kate, I see that you recently updated your FODMAPS checklist. I just want to confirm a couple of things:
1) Was grapefruit moved out of the low FODMAPS category?
2) Are all colored bell peppers low FODMAPS (Red AND green/yellow)?

Thanks Kate for the info
Does the 4th ed of the monash university low Fodmap diet book (available from Australia) have all the latest testing in it? I bought the authors’ American version low Fodmap diet book with menus etc but still see huge holes in terms of potential foods not addressed there.
As for almond milk, and other nut and seed milks I make, the soaking water is discarded prior to blending the nuts with fresh water, therefore.. based on what you wrote, I assume that most of the GOS is washed away with the soaking water. Does that sound right?

Chris–some of the GOS/fructans will be washed away in the soaking liquid–not sure if enough to make the milk low FODMAP. The app is the best way to go to get the latest food info from Monash University. Do you have an iPad, iPhone or android phone. It might be a great resource for you. The app is called: The Monash University Low FODMAP diet app.

Yes, I agree with Patsy’s info on soy–a great recap! Silk tofu from what we understand is prepared in a way that the FODMAPs likely remain–it’s congealed rather than drained of the water soluble fibers. Firm tofu–traditionally made–drained of excess liquid should be okay.

Hi Chris, the low FODMAP diet is evolving–and will continue to be modified for some time as new foods are tested. Apple Cider Vinegar has not been added to the Monash app–but USDA data reveals that it has more fructose than glucose –but in very small amounts. Unfiltered apple cider vinegar could have more do to the particles left behind. I trust the Monash data as it is up to date… Balsamic vinegar was shown to be a source of excess fructose in a serving size >2 Tablespoons and US data shows balsamic as NOT being a source of excess fructose. So, as you can see–and as I am sure you are aware–practitioners educating patients on the low FODMAP diet need to make many best educated decisions.

Hi Karen….Molasses has not been tested yet and might be a source of excess fructose. I discourage its use during the elimination phase of the diet. And I don’t have data on all of the gluten free grains BUT I have been told by the Monash team that the gluten free grains in general, have less FODMAPs than wheat. Because the diet continues to evolve– as a practitioner– I have had to make some “best educated” guesses. And so, I do allow sorghum, buckwheat, amaranth and millet with my clients. Hopefully we will get more info from soon from the Monash team!

Hi Karen, I thought I responded to you but not sure it went through on the blog!
Molasses is probably high fructose–but we are awaiting Monash U to test it! And although many of the gluten free grains have been tested we don’t have this information–it’s not published yet. BUT I have been told by the Monash research team that gluten free grains –in general–have less FODMAPs than wheat. So I do allow them–but this may change when I learn more about them.

Hi Chris–I think all onion products even powder should be avoided in the early stages of the diet. Traces of wheat such as a handful of plain pretzels or a dusting of wheat flour on chicken should not pose a problem. I do recommend that my clients avoid wheat for the most part though if possible.

Thanks so much, Kate. I’ve been following the FODMAPs diet pretty strictly since May. I do feel better, but I still don’t feel great a lot of the time. Is there any evidence that after following the diet for a year or two that you can begin eating some of the high FODMAPs foods again? I noticed in your comment to Chris that you advised avoiding onion in the early stages of the diet. Does that mean you can have a little onion at a later point? I really appreciate your blog. Peace & Joy to you this holiday season!

Not sure I got back to you on this question Karen…tolerance to FODMAPs can change over time–likely due to changes in gut bacteria that can occur with diet changes or treatment of bacterial overgrowth. Onion, however, seems to be one of the hardest FODMAP sources to add back. But, it is always worth doing the full re-introduction/challenge phase and assess your personal tolerance.

I’ve been attempting the FODMAPS diet with the help of your downloaded lists(thank you so much for posting updates!)but am pretty overwhelmed. I saw that you did a workshop in Bridgeport, CT in April 2013 which is close to where I live. Are you able to suggest a registered dietician who may have participated or who is knowledgeable in FODMAPS, practicing in CT?
Much appreciated!

thx for all of the useful information, I often google fodmap issues and ended up on your site several times.

Today I was looking for Lucuma, Mesquite and Avocado Oil.

Do you know if Lucuma is low fodmap? As far as I can see, it’s a fruit and not a legume, so it might be ok, don’t know if it belongs to any fruit “category” which makes it likely high or low in fodmap?

Guess Mesquite is high as it is a legume, what a shame!

Also I was wondering if avocado oil is ok, thought that the oil cannot be compared to the flesh of the fruit, sort of compared it with using onion or garlic to infuse oil (which I have not done yet myself), since the avocado oil does not as such contain the fiber/carbohydrates, would it be ok to use?

Wanted to use it in a recipe for homemade mayo, could always substitute it with another oil, but I like avocado oil which I have used before I knew (and needed) about the fodmap diet.

thx for the reply, I used both avocado and hemp seed oil for the mayo and didn’t seem to have a problem with that It was a “paleo mom” recipe, also a great site for nice recipes!

I have another tricky question, I would like to buy a protein powder, but whey apparently contains a lot of lactose, some sites say it does not, some say it does, very confusing, I cannot tolerate fermented products, so rice protein powder is also a no go, egg protein would be possible, but I would like a vegetarian product, as I do eat a lot of meat, I thought about hemp or pea protein, don’t know how pure they are, if the protein part is totally extracted so that the fiber (fodmap) part is not there anymore? Do you know the answer to this?

Maybe the taste would be too strong to use it for granola bars, smoothies anyways? Do you have any experience with legume protein powders?

Anne–My Dad was born in Cologne, Germany. Glad you found me all the way from Munich! Munich is on my list of places to visit!
Whey protein powders that contain Whey protein isolate only–should be suitable. Whey protein concentrates may have lactose. We don’t know about pea protein as of yet or other legume powders for that matter–though I did send some pea protein powders for analysis–hopefully we’ll get some info soon. Egg white protein powders are commonly used by my clients w/ excellent tolerance.

1) I saw that chamomile and fennel tea are now on the high FODMAP list. Chamomile has always been my go-to tea for settling my stomach. How much FODMAP does it contain? Should I avoid it? Also, I’ve been taking enteric-coated peppermint oil caps that contain small amounts of fennel and ginger oil. Could these be harming rather than helping my IBS?

2) I’ve been looking at reports that carrageenan can be a problem for people with IBS. What are your thoughts on carrageenan?

The FODMAP content of chamomile and fennel is quite high from info that I have seen from Monash University. I would try avoiding it and see if you note improvements. BUT remember we all have a personal and individual tolerance to FODMAPs and so perhaps for you–it might be helpful.
Oils should not be a source of FODMAPs–FODMAPs are carbs –so I would guess that the oils added to the peppermint oil would be okay.
Carrageenan–is not a fodmap, BUT–I think, it would be advisable for humans to limit it’s consumption as it is associated with a risk of intestinal cancer. http://www.ncbi.nlm.nih.gov/pubmed/11675262 It’s in many, many products–probably small amounts might be okay–but this is why I constantly repeat this notion: EAT food from a plant–not made in a plant. Less manufactured foods should be our goal.

In case it is helpful… I love ginger tea or peppermint tea for soothing my stomach (or just to get warm!). Try to find plain ginger tea, as some of the blends contain chamomile (and other potential FODMAPs). Traditional Medicinals makes a plain organic ginger tea.

I started the low FODMAP diet end of September and it’s been working really well for me. However I’m now in the challenge phase and I’m finding it really…well…challenging. So far everything except oats and lactose seems to be setting me off and that just doesn’t seem right. I’m wondering if it’s about time of day and combinations with other food so I’m re-testing with challenge foods first thing in the morning and waiting half an hour before eating anything else to see if symptoms appear. Does that sound about right?

Also, I’m an avid runner and have just started marathon training again. On my long-run days in particular I’m struggling because my body needs carbohydrates for fuel and recovery, but that sets off symptoms. Do you know of anywhere that I could find information about meeting my nutritional requirements without tipping into high FODMAP territory?

Rebecca–Can you work with a dietitian to help you with the challenge phase and tips to help manage your caloric intake while training? Bananas and peanut butter are my go to favs for easy digestion and calories. And if you can’t get any foods back in–then I would be a bit suspicious of small intestinal bacterial overgrowth. I am a runner-and marathoner too….but it can be tough on your GI tract –so I wish you could get your gut in working order b/4 you trained for your big event. At a minimum, try to minimize the long runs–maybe to one per week.

Rebecca–Can you work with a dietitian to help you with the challenge phase and tips to help manage your caloric intake while training? Bananas and peanut butter are my go to favs for easy digestion and calories. And if you can’t get any foods back in–then I would be a bit suspicious of small intestinal bacterial overgrowth. I am a runner-and marathoner too….but it can be tough on your GI tract –so I wish you could get your gut in working order b/4 you trained for your big event. At a minimum, try to minimize the long runs–maybe to one per week.

This is a great question and one I wonder about. I do see some IBSers with very high B12 levels–out of the ball park –and expect this is some type of bacterial production of B12. Some bacteria do produce B12 but I have not seen much in the research suggesting that the human body absorbs it and it raises the blood values. On the other hand, there is evidence of elevated blood folate levels due to bacterial production and evidence of reduction of B12 due to bacterial consumption of the vitamin. The science of gut bacteria and its impact on health is exploding but still very much in its infancy…so we’ll know more soon enough…..but not a ton of data on this yet.

Thanks for the reply Kate. Just from my little bit of searching of info on high b-12, I couldn’t come up with any specific research studies on it, but figured if anyone was going to know, you would be the one with all your work in this area and from the conferences you attend. Sounds like lots to learn on these necessary bacteria we have that can cause lots of issues if they overgrow. Anyways, you saved me time searching for studies that are not done yet. Thanks for your reply.

Hi Kate! I’ve read here that oil infused with onion is OK. How about something that’s been marinated with onion? For example, there’s a ceviche dish I absolutely love but it’s loaded with onions. Can I safely remove the onions and just eat the seafood? Similarly, can I strain the onions from my favorite brand of non-garlic marinara sauce?

Hi Anna, Onion and garlic are sources of fructans, which are water soluble fiber. So when sautéing the onion or garlic in oil-the fructans will not leach into the oil. (water doesn’t mix with oil) BUT because the fructans are water soluble they will mix with something that is water based like soup or tomato sauces… Certainly removing the onion from soup will lower the fructan load….but likely not enough.

Hi Kate. I have SIBO. I follow the low FODMAPS and mainly eat veges and meat. If I eat too much rice and gluten free products, my lower stomach feels heavy. But when I do eat these, I’ll have a cabbage juice and it settles it almost immediately. I notice cabbage is high in FODMAPS.I don’t seem to have any gas from it but is it still affecting the SIBO? I also have read that cabbage and garlic juice are great for killing bacteria in the intestine. My whole digestive system often feels cleansed by drinking it.So now that makes it more confusing for me!

Also, I’ve gone to probably 50 websites with FODMAPs listing. They often seem to conflict as to if they’re high or low! Even the major hospital and medical sites! Some say almonds and hazelnuts are low, other say high, some say ripe banana, others unripe is better. Some say cherries and all seeds are OK, some not, some say oat milk and oatmeal are OK, some not. I do understand that the type of gluten in oats is different to other gluten grains, is this why? But it is still classified as gluten. So is it SIBO friendly or not and what do you understand about the other foods I mentioned. I thought it would be a simple matter of finding out what FODMAPs are in each food product and listing it, simple as abc. How can people test it all differently??!

Hi Sharon, Common cabbage-the smooth type is actually low FODMAP. I believe that the Monash University research is the most up to date–with FODMAP food analysis and this is what I follow and include in my info here on the blog. There are many lists online for low and high FODMAP foods–the key is to find an up to date resource–and I do try to keep my check list up to date. As research has evolved with the low FODMAP diet- new and more up to date food analysis have been done–some websites are posting old data. I do not believe oat milk has been tested. Almond and hazelnuts may be consumed on the low FODMAP diet but are limited to a small serving: 10 nuts. From a FODMAP standpoint ripe or unripe should be appropriate from a FODMAP standpoint. Oats naturally do not contain gluten–they are typically contaminated with gluten in the growing fields or on machinery that processes them. The low FODMAP diet is not as you say, “simple as a, b, and c.” It is best done with a registered dietitian well versed in the diet. The internet can provide some great info…but as we all know–not everything you find is accurate or up to date!

I also wondered about butternut squash and coconut milk/cream and here in Australia we now have a low GI brown rice.. as these are also conflicting.

The other question I have is to do with higher GI products influencing sibo as I have hyperinsulinemia. My pancreas gives off too much insulin so I’m on a low GI diet to control it. However, the gluten free grains exept quinoa are all high GI, unless they’ve been lowered by putting soy in their bread which of course is high fodmaps. The problem I have is I’m often hungry. I have tried to add seeds to say a pancake mix to bring the gi level down. So what I’m asking is does the pancreas also affect sibo? What do you understand about these things? Thank you for your advice.

Butternut squash has some FODMAPs–the cut off amount is a measly 1/4 cup so might not be work having! Perhaps a little mixed into your quinoa might be an option! As for GI foods–it really depends on why something might be lower GI–if it’s because it has some fat and fiber–that are not big FODMAP sources–it might be okay. I have not heard of low GI rice. We do have a low GI pasta–but it is rich in resistant starch–which can make some people gassy! With my clients I try to add fiber (low FODMAP sources) and healthy fats (acceptable nut butters, pumpkin seeds, chia seeds, olive oil) to their meals to avoid a fast rise in sugar and they also tend to feel fuller. Please clarify your pancreas question…I am not sure what you are asking.

Leslie, not sure… The Monash team allows dry wines and beer on their app–and don’t exclude particular beer–but I do wonder with all the varieties of beer and literature I have read about beer that some may indeed have mannitol. Maybe this should be my next research project?! From my patients perspective a glass of wine seems to be the best tolerated. Of course, alcohol is a GI irritant –can draw water into the intestine, as well–so we should likely limit consumption to 1-2 drinks max!

Thanks Kate. Sounds like a great research topic to me! I have often wondered why on some occasions I would have symptoms after a glass of wine or beer, but on other occasions be symptom free. It was only after I saw your earlier post about mannitol that I wondered if that might be the cause (especialy since I am highly intolerant to polyols). I guess I’ll just have to keep better track of which brands seem to bother me and which brands don’t. Thanks again!

Help!!
I have a couple of things that I need help with.
1) Can you recommend an RD in Iowa who is familiar with FODMAPS and vegan diets?
2) I’m confused about carageenan, guar gum/other gums and inulin. I noted in a previous post coconut milk yogurt is OK but all that I found has inulin in them which I understand to be a no-no..what’s the verdict?
3) I’m vegan and just getting started on low FODMAPS as I have been suffering for years. Do you have any recommendation for vegan, FODMAP friendly vitamin supplements..particularly B12 and Vit D. I can find either vegan or FODMAP friendly but not both.
4) finally-whats the verdict on nutritional yeast. I have been planning to use some to get my B12, but not sure it’s safe. Unfortunately I haven’t been able to find any supplements of B12 that are safe..as noted above
Thank you so much for your time. Your site has been a wonderful and valuable resource for me as I begin this difficult journey of being vegan and low FODMAP.

Hi Michelle,
Welcome to my blog! I am glad you have found it to be useful as you navigate the low FODMAP diet.
I don’t know of an RD in Iowa who is familiar with FODMAPs–check out the RD registry on IBSfree.net that may offer some guidance. I was actually just asked to speak in Iowa on FODMAPs–though not til later this year…so will have a better idea later in the year!
Carrageenan, guar gum and pectin are not FODMAPs (they are longer chains of carbohydrates than FODMAPs) though guar gum and pectin are rapidly fermentable so may contribute to gas symptoms in those with IBS. I am not a fan of carrageenan due to animal studies linking it with intestinal cancer and inflammation. Overall, my recommendation is to limit food products and enjoy food from Mother Nature as much as possible! Probably small amounts of these additives are okay–but when individuals rely on food products consumption of additives increases along with the products!
I believe this Metabolic Maintenance is vegan–check it out: http://www.metabolicmaintenance.com/product/Basic_Maintenance/vitamins_minerals
Not sure about nutritional yeast–I think it would be okay though. (vitamin above has plenty of b-12) And in theory coconut milk yogurt would be okay–but you are right most contain chicory root or inulin and that is a FODMAP source.
Hope that helps!

Wow, thank you so much for the incredibly fast reply!! That would be so great if you came to Iowa to speak. I do have a couple more questions..hope you don’t mind
1) I saw on the Monash App that canned lentils are OK. What’s your thoughts on this and should it be avoided during the elimination phase?
2) Can I eat more than one moderate item in a sitting..for example I made a tofu scramble with sweet potato, tofu and broccoli and had some roasted brussel sprouts on the side. All items were under the recommended 1/2 cup but I didn’t know if combining is a problem.
Thank you so much for all your help and work.

Michelle–combining moderate sources of FODMAPs is not allowed on elimination phase as it would put the overall FODMAP load too high! Try to limit to one choice per meal or snack. Hope that helps. Gotta run!

What about glycerine? I read its a polyol. Its a base it seems in a number of supplements that I have been taking. Since discovering this, I have cut them out, except for one which I take 15 drops to help with sleep. What are your thoughts – is it critical to eliminate ALL polyols? I notice also that erythritol is OK even though its a polyol.

Hi Chris, I thought I answered your question …sorry ’bout that. Glycerin/glycerol are sugar alcohols. Typically the amount in a supplement should be inconsequential but if you had multiple supplements or food products–then it may add up and contribute to symptoms. Erythritol is considered well absorbed so in theory should not pose a problem/trigger GI symptoms… But one study did show that it contributed to GI symptoms when ingested w/ fructose: http://www.ncbi.nlm.nih.gov/pubmed/22118754 Additionally, a study out of Monash U last year also noted that despite mannitol and sorbitol being absorbed better by those with IBS compared to healthy controls…the sugar alcohols contributed to GI symptoms in the IBS patients. SO…what I take from that study is that even if some of the FODMAPs are NOT malabsorbed by an individual with IBS they still MAY contribute to GI Symptoms–likely due to the nature of them drawing water into the intestine when they are present. If you have a sensitive intestine–the distention from the water may trigger symptoms. So in my opinion, if the supplement is not triggering symptoms you might be okay.

Helena–Glad you asked. Not necessarily–it may contribute to IBS-D in an individual with rapid intestine transit–but in someone with IBS-C it might feel like you have a big fat water balloon filled with water and air sitting in the middle of your belly.

HI Kate! I have really troubles with the amounts..
1) Suggested amounts for vegetables are “normally” 120 grams per serving (swiss society for nutrition). May I eat for example 120 grams of low-FODMAP green beans or ratatouille made out of FODMAP-low vegetables (tomatoes, zucchini, eggplant, red bell pepper)? Or are even the low FODMAP vegetables limited per serving?
2) Suitable fruits are limited to 1 serving per meal. But as FODMAPS accumulate, why does Sue Shepherd propose a main-meal with vegetables and a fruit for dessert? Does that mean that I may combine 1 serving of EACH FODMAP in one meal? Please help! Thank you so much!!

This is a very good question. If we had all the data to add up all the fodmaps in a meal and limit it to the 0.5 grams of total fodmaps as outlined by the Monash U team as a good mealtime limit–we could perhaps with some difficulty use this in practice….but many of the food analysis data is unpublished and some of the universal data that is available is outdated and inaccurate. In my practice, I allow low FODMAP veggies with in reason–a normal size side salad or 1/2 plate of sauteed low FODMAP veggies –unless the vegetables were in the moderate fodmap range–such as butternut squash, broccoli etc…only 1 moderate fodmap veggie per meal in the limit specified by the Monash app. 1 low FODMAP fruit limit per meal helps limit the fructose load per meal (although this concept of fructose load has not been studied in the IBS population! we think this is beneficial) So..to answer your question, in my practice as it stands right now, I would allow ratatouille. I would not encourage my patient to eat a bowl of ratatouille the size of their head but rather fill half the plate or slightly less of it. Then I encourage perhaps a potato or rice which is low to zilch in FODMAPs. I would allow my clients to eat a piece of acceptable low FODMAP fruit for dessert and low FODMAP veggies at the same meal. I have found only a handful of clients need to be super strict –and in my experience –those who are SUPER sensitive to FODMAPs have small intestinal bacterial overgrowth-so I am sure to have them tested and treated!

Thanks for all the great help kate!
My latest conundrum is digestive bitters, which I want to try due to low stomach acid. The mixes all have some dandelion in them. Is that OK on fodmaps diet or not? I have read that dandelion tea is not allowed on the diet. Any knowledge about bitters that are compatible with the diet would be appreciated.

Darn it
I just bought a bunch of dandelion tea to help with water retention. Dehydration is a lovely side effect of a new medication I’m taking so my body is retaining lots of water even though I’m drinking all the time. Do you know of anything that helps eliminate excess water that is FODMAP friendly?

Thanks for all of your help, you really do make following this diet a lot easier! I’m training for a marathon and struggling to eat enough to keep up with my training. I’m looking to make some homemade FODMAPs free flapjacks and just wondered if it’s ok to add dried fruit? I have seen some recipes online that include raisins or dried fruit and wasn’t sure if that was ok.

Steph most dried fruit is not allowed as it a source of fructans-prunes also have sorbitol. Dried cranberries slip under the FODMAP cut off but only in <1 tablespoon serving. Perhaps try adding bananas, blueberries or strawberries and some walnuts or pecans to add some flavor to your flapjacks. If you tolerate peanut butter –that is a filling low FODMAP calorie, protein and magnesium boost for you. Would encourage you work with a dietitian that can help you be creative w/ your diet to ensure adequate nutrition for your big race. A multivitamin during this training phase may also be a good idea.

Thanks for all the great info. You mention that SIBO might be an issue in FODMAP intolerance. From all I’ve read on the topic I suspect this might be the case for me. Do you think dietary changes (ie eating low-fodmap for a while) can be sufficient to treat SIBO?

Also, I seem to be supersensitive to GOS (excessive nuts and any amount of legumes will give me a killer backache, for one) while onion/garlic and most high-fodmap vegetables don’t seem to bother me that much. I’m trying to figure out the mechanism behind this and I’m testing my tolerance level for different cooking methods. Do you have any information on how sprouting legumes affects their FODMAP content?

I am doubtful that diet measures alone can treat SIBO–but perhaps. We need more research in this area. I believe the low FODMAP diet might be helpful in managing symptoms of SIBO –at least partly. You may have gut flora (bacteria/microbes) that prefers GOS fibers as their food source…and perhaps these bacteria contribute to toxic metabolites or a leaky gut which impacts you on a systemic level–ie back pain. –just an idea–theory–that needs more evidenced based research…but something to think about.

Hi Kate,
I have just started following the low FODMAP diet. I have been using the Monash Uni app to guide me however I am confused about some things. Are all the recipes on the app ok for the elimination phase? Some foods that come up blocked when I set the filters for the elimination phase are still in the recipes. For example sweet potato is blocked out however it appears in one of the recipes (lasagna I think). Is it because the serving size is small and therefore ok? Also what is maltodextrin and is it ok in a low fodmap diet?
Thanks for your help.

Bee, I am assuming you are referring to the recipes in the app, correct? If the sweet potato is under the FODMAP cut off then I allow in the recipe. Maltodextrin is not a fodmap source by definition so we allow itR